Creating diagnostic criteria for perforated appendicitis using cross-sectional imaging

Church, John; Coughlin, Megan A.; Antunez, Alexis G.; Smith, Ethan A.; Bruch, Steven W.

doi:10.1007/s00383-017-4121-4

Cited by 4 publications

(6 citation statements)

References 22 publications

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“…7,33 Differentiating complicated from uncomplicated appendicitis in the preoperative setting can be challenging, and a change from cefoxitin to a more broad-spectrum regimen after complicated disease is recognized intraoperatively may result in treatment delay and potentially higher risk of SSI. [34][35][36] The results of this study must be interpreted in the context of its limitations. Although NSQIP-Pediatric utilizes a rigorous chart review process and standardized definitions for both exposures and outcomes, data collected in NSQIP-Pediatric are retrospective and errors in misclassification and identification of outcomes are possible.…”

Section: Discussionmentioning

confidence: 90%

“…Furthermore, cefoxitin is not recommended for treatment of complicated appendicitis by the Surgical Infection Society or consensus guidelines endorsed by the American Society of Hospital Pharmacists and Infectious Disease Society of America 7,33 . Differentiating complicated from uncomplicated appendicitis in the preoperative setting can be challenging, and a change from cefoxitin to a more broad-spectrum regimen after complicated disease is recognized intraoperatively may result in treatment delay and potentially higher risk of SSI 34–36 …”

Section: Discussionmentioning

confidence: 99%

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Association Between Antibiotic Redosing Before Incision and Risk of Incisional Site Infection in Children With Appendicitis

et al. 2022

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Objective: To evaluate whether redosing antibiotics within an hour of incision is associated with a reduction in incisional surgical site infection (iSSI) in children with appendicitis. Background: Existing data remain conflicting as to whether children with appendicitis receiving antibiotics at diagnosis benefit from antibiotic redosing before incision.Methods: This was a multicenter retrospective cohort study using data from the Pediatric National Surgical Quality Improvement Program augmented with antibiotic utilization and operative report data obtained though supplemental chart review. Children undergoing appendectomy at 14 hospitals participating in the Eastern Pediatric Surgery Network from July 2016 to June 2020 who received antibiotics upon diagnosis of appendicitis between 1 and 6 hours before incision were included. Multivariable logistic regression was used to compare odds of iSSI in those who were and were not redosed with antibiotics within 1 hour of incision, adjusting for patient demographics, disease severity, antibiotic agents, and hospital-level clustering of events. Results: A total of 3533 children from 14 hospitals were included. Overall, 46.5% were redosed (hospital range: 1.8%-94.4%, P < 0.001) and iSSI rates were similar between groups [redosed: 1.2% vs non-redosed: 1.3%; odds ratio (OR) 0.84, (95%,CI, 0.39-1.83)]. In subgroup analyses, redosing was associated with lower iSSI rates when cefoxitin was used as the initial antibiotic (redosed: 1.0% vs nonredosed: 2.5%; OR: 0.38, (95% CI, 0.17-0.84)], but no benefit was found with other antibiotic regimens, longer periods between initial antibiotic administration and incision, or with increased disease severity. Conclusions: Redosing of antibiotics within 1 hour of incision in children who received their initial dose within 6 hours of incision was not associated with reduction in risk of incisional site infection unless cefoxitin was used as the initial antibiotic.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Association Between Antibiotic Redosing Before Incision and Risk of Incisional Site Infection in Children With Appendicitis

et al. 2022

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“…По мнению M. Tarulli и соавт., методика фокусированной КТ с внутривенным и пероральным контрастированием при подозрении на ОА позволяет визуализировать отросток в 95% случаев [33]. По данным некоторых авторов, модифицированные протоколы КТ даже более специфичны в сравнении с МРТ для осложненных форм ОА [34], в том числе и для детей с подозрением на ОА [35]. Еще одним важным преимуществом КТ является высокая информативность в диагностике новообразований аппендикса.…”

Section: компьютерная томографияunclassified

“…при сравнении диагностической точности КТ и МРТ у пациентов с подозрением на ОА было установлено, что МРТ имеет б ольшую чувствительность -86,7-90%, но меньшую специфичность -74-97,1% (для КТ показатели представлены в табл. 3) [34,35]. МРТ-технология DWI получила широкое применение при исследовании брюшной полости благодаря эхопланарной визуализации, которая ускоряет получение изображений и уменьшает артефакты.…”

Section: мрт брюшной полости и тазаunclassified

Radiation methods in the diagnosis of acute appendicitis (literature review)

Katrich,

Polshikov,

Katrich

2023

Medicinskaâ vizualizaciâ

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Aim. Analysis of the literature and comparative evaluation of data on the effectiveness of instrumental radiological diagnostic methods in patients with suspected OA.Material and methods. A search was made for scientific publications, clinical recommendations, reports of congresses and scientific conferences in the information and analytical systems PubMed, Google Scholar and ELibrary for 2013–2022. by the following keywords: acute appendicitis, diagnosis of acute appendicitis, intestinal ultrasound, computed tomography in the diagnosis of acute appendicitis, CT and acute appendicitis, MRI for acute appendicitis, radiodiagnosis of appendicitis, radiodiagnosis of intestinal pathology, diagnosis of acute appendicitis, ultrasound, CT, MRI in the diagnosis of acute appendicitis. In addition, the literature lists were analyzed to find articles that match the search criteria.Results. 264 articles were analyzed, including publications of scientific conferences and congresses, 50 of which were used to compile the review. From the lists of references, 9 articles for 2020–2022 were additionally included. Search results – blocks of articles were created, within which the material was analyzed to study the questions posed.Conclusion. Each of the radiological methods in the diagnosis of OA has strengths and weaknesses. Knowledge of these features, as well as the equipment of the hospital, can determine the choice of the method of radiation diagnostics in case of suspected OA. An analysis of the literature data on the comparison of the effectiveness of ray methods and the sequence of their application dictates the need to continue research in this direction.

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“…According to studies discussing the role of CT in the diagnosis of complicated appendicitis in the literature, there is no specific CT finding used to predict the presence of complicated appendicitis (11)(12)(13)(14). Some studies investigate the role of various scoring systems used for establishing appendicitis intensity in the diagnosis of acute appendicitis (15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Is acute appendicitis complicated or uncomplicated? Approaching the question via computed tomography

2022

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Background The distinction between complicated and uncomplicated appendicitis is very important for the selection of the treatment method. Purpose To investigate the sensitivity and specificity of computed tomography (CT) in differentiating between complicated and uncomplicated appendicitis to demonstrate that false negativity in differentiating these cases can be reduced when CT findings are incorporated into the clinical evaluation of patients. Material and Methods All patients aged ≥18 years who underwent appendectomy at Malatya Training and Research Hospital in 2020 and 2021 were retrospectively screened. Of them, 283 patients were included in the study who had undergone CT before the operation. Patients with appendicitis were divided into two groups: complicated and uncomplicated, according to the results of their pathology tests. Demographic data, laboratory results, and CT images of the patients were evaluated. Results The patients with complicated appendicitis had a significantly higher mean age ( P<0.001). The most common CT findings in patients with complicated appendicitis were moderate or severe peri-appendiceal fat stranding (PFS) and appendix wall enhancement defect (AWD). The findings with the highest sensitivity were PFS (77.9%) and AWD (69.4%). Although abscess, phlegmon, and peri-appendiceal air had the highest specificity (100%), these findings were the ones with the lowest sensitivity. According to the scoring system was developed for the differential diagnosis, CT had a sensitivity of 83.3% and a specificity of 79.2%. Conclusion Based on the sensitivity and specificity values measured for CT according to the findings of our study, the scoring system may be useful for the differential diagnosis of complicated appendicitis.

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Creating diagnostic criteria for perforated appendicitis using cross-sectional imaging

Abstract: MRI trended toward more sensitive and CT was more specific for complicated appendicitis. CT specificity is improved by our algorithm.

Cited by 4 publications

References 22 publications

Association Between Antibiotic Redosing Before Incision and Risk of Incisional Site Infection in Children With Appendicitis

Association Between Antibiotic Redosing Before Incision and Risk of Incisional Site Infection in Children With Appendicitis

Radiation methods in the diagnosis of acute appendicitis (literature review)

Is acute appendicitis complicated or uncomplicated? Approaching the question via computed tomography

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