A Clinicopathological Study of Emergency Appendectomy

Zourob, Mohammed; Baithun, Suhail; Cunningham, Francis O.

doi:10.12816/0047510

Cited by 2 publications

(1 citation statement)

References 15 publications

(19 reference statements)

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“…Acute appendicitis is the most common urgent surgical disease with various manifestations and complications [8,13]. In developed countries, the incidence of acute appendicitis occurs in 5.7-89 patients per 100,000 population, with a peak at the age of 10-30 years [7,11].…”

Section: Introduction / вступmentioning

confidence: 99%

Effectiveness of Lymphotropic Therapy in the Patients With Acute Appendicitis and Its Complicated Forms

Duzhyi

Shimko²,

Pyatikop

et al. 2023

EUMJ

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Introduction. Despite using the latest generations of antibiotics and modern methods of their introduction in the surgical treatment of acute appendicitis, purulent-septic complications keep occurring, accounting for 45% of fatal outcomes in the patients operated on for this disease. Materials and methods. Patients were divided into two groups. The main group included patients who were administered antibiotics and pathogenetic drugs locally to the ileocecal zone by means of lymphotropic administration. The comparison group included patients who received standard antibiotic therapy. Results. On the 5th day of the postoperative period, the level of IgA in the main group was 1.16 ± 0.7 mg/ml, and in the comparison group – 1.54 ± 0.8 mg/ml. The level of elastase in the operated patients of the main group decreased to 111.797 ± 21.39 nmol/min × ml, i.e., by 2.4 times (p <0.001), and in patients of the comparison group – to 179.605 ± 26.79 nmol/min × ml, i.e., by 1.5 times (p <0.05). Under the influence of lymphotropic administration of the antibiotic, the volume of the spleen decreased by the 5-th day to 281.22 ± 18.8 cm³, i.e., 145.44 cm³, and with standard administration of antibiotics, the spleen decreased within the period to 344.71 ± 21.13 cm³, i.e., by 79.54 cm³, which is less by 66 cm³, or 1.8 times (p <0.05) vs. main group. Conclusions. The proposed method of antibiotic therapy is a preventive measure against purulent-septic complications, especially in its destructive forms, improves the results of treatment of patients with acute appendicitis, and shortens their term of staying in the hospital, which has a positive impact on financial status.

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Section: Introduction / вступmentioning

confidence: 99%

Effectiveness of Lymphotropic Therapy in the Patients With Acute Appendicitis and Its Complicated Forms

Duzhyi

Shimko²,

Pyatikop

et al. 2023

EUMJ

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Computed tomography for diagnosis of acute appendicitis in adults

Rud

Vejborg

Rappeport

et al. 2019

Cochrane Database of Systematic Reviews

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Cochrane Database of Systematic Reviews Data collection and analysisTwo review authors independently collected the data from each study and evaluated methodological quality according to the Quality Assessment of Studies of Diagnostic Accuracy -Revised (QUADAS-2) tool. We used the bivariate random-e ects model to obtain summary estimates of sensitivity and specificity. Main resultsWe identified 64 studies including 71 separate study populations with a total of 10,280 participants (4583 with and 5697 without acute appendicitis). Estimates of sensitivity ranged from 0.72 to 1.0 and estimates of specificity ranged from 0.5 to 1.0 across the 71 study populations. Summary sensitivity was 0.95 (95% confidence interval (CI) 0.93 to 0.96), and summary specificity was 0.94 (95% CI 0.92 to 0.95). At the median prevalence of appendicitis (0.43), the probability of having appendicitis following a positive CT result was 0.92 (95% CI 0.90 to 0.94), and the probability of having appendicitis following a negative CT result was 0.04 (95% CI 0.03 to 0.05). In subgroup analyses according to contrast enhancement, summary sensitivity was higher for CT with intravenous contrast (0.96, 95% CI 0.92 to 0.98), CT with rectal contrast (0.97, 95% CI 0.93 to 0.99), and CT with intravenous and oral contrast enhancement (0.96, 95% CI 0.93 to 0.98) than for unenhanced CT (0.91, 95% CI 0.87 to 0.93). Summary sensitivity of CT with oral contrast enhancement (0.89, 95% CI 0.81 to 0.94) and unenhanced CT was similar. Results show practically no di erences in summary specificity, which varied from 0.93 (95% CI 0.90 to 0.95) to 0.95 (95% CI 0.90 to 0.98) between subgroups. Summary sensitivity for low-dose CT (0.94, 95% 0.90 to 0.97) was similar to summary sensitivity for standard-dose or unspecified-dose CT (0.95, 95% 0.93 to 0.96); summary specificity did not di er between lowdose and standard-dose or unspecified-dose CT. No studies had high methodological quality as evaluated by the QUADAS-2 tool. Major methodological problems were poor reference standards and partial verification primarily due to inadequate and incomplete follow-up in persons who did not have surgery. Authors' conclusionsThe sensitivity and specificity of CT for diagnosing appendicitis in adults are high. Unenhanced standard-dose CT appears to have lower sensitivity than standard-dose CT with intravenous, rectal, or oral and intravenous contrast enhancement. Use of di erent types of contrast enhancement or no enhancement does not appear to a ect specificity. Di erences in sensitivity and specificity between low-dose and standard-dose CT appear to be negligible. The results of this review should be interpreted with caution for two reasons. First, these results are based on studies of low methodological quality. Second, the comparisons between types of contrast enhancement and radiation dose may be unreliable because they are based on indirect comparisons that may be confounded by other factors.How reliable are the results of the studies in this review? Among the included studies, th...

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A Clinicopathological Study of Emergency Appendectomy

Cited by 2 publications

References 15 publications

Effectiveness of Lymphotropic Therapy in the Patients With Acute Appendicitis and Its Complicated Forms

Effectiveness of Lymphotropic Therapy in the Patients With Acute Appendicitis and Its Complicated Forms

Computed tomography for diagnosis of acute appendicitis in adults

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