Acute appendicitis: position paper, WSES, 2013

Agresta, Ferdinando; Ansaloni, Luca; Catena, Fausto; Verza, L. A.; Prando, Daniela

doi:10.1186/1749-7922-9-26

Cited by 9 publications

(9 citation statements)

References 34 publications

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“…A comprehensive physical examination, close observation and serial diagnostic testing were found to be effective means to lower the risk of adverse outcome (35,36). This conclusion is supported by the data of a systematic review and meta-analysis of the scientific literature, showing that the length of hospital stay and the rate of complications or readmission were not significantly different when comparing active observation with early laparoscopic intervention (37).…”

Section: Discussionsupporting

confidence: 66%

Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5,340 cases

et al. 2016

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Background: Acute abdominal pain (AAP) accounts for 7-10% of all Emergency Department (ED) visits.Nevertheless, the epidemiology of AAP in the ED is scarcely known. The aim of this study was to investigate the epidemiology and the outcomes of AAP in an adult population admitted to an urban ED. Methods:We made a retrospective analysis of all records of ED visits for AAP during the year 2014. All the patients with repeated ED admissions for AAP within 5 and 30 days were scrutinized. Five thousand three hundred and forty cases of AAP were analyzed.Results: The mean age was 49 years. The most frequent causes were nonspecific abdominal pain (NSAP) (31.46%), and renal colic (31.18%). Biliary colic/cholecystitis, and diverticulitis were more prevalent in patients aged >65 years (13.17% vs. 5.95%, and 7.28% vs. 2.47%, respectively). Appendicitis (i.e., 4.54% vs. 1.47%) and renal colic (34.48% vs. 20.84%) were more frequent in patients aged <65 years. NSAP was the most common cause in both age classes. Renal colic was the most frequent cause of ED admission in men, whereas NSAP was more prevalent in women. Urinary tract infection was higher in women. Overall, 885 patients (16.57%) were hospitalized. Four hundred and eighty-five patients had repeated ED visits throughout the study period. Among these, 302 patients (6.46%) were readmitted within 30 days, whereas 187 patients (3.82%) were readmitted within 5 days. Renal colic was the first cause for ED readmission, followed by NSAP. In 13 cases readmitted to the ED within 5 days, and in 16 cases readmitted between 5-30 days the diagnosis was changed.Conclusions: Our study showed that AAP represented 5.76% of total ED visits. Two conditions (i.e., NSAP and renal colic) represented >60% of all causes. A large use of active clinical observations during ED stay (52% of our patients) lead to a negligible percentage of changing diagnosis at the second visit.

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Section: Discussionsupporting

confidence: 66%

Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5,340 cases

et al. 2016

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“…Maybe the contemporary diet has an influence on this result. On the other hand, the number of seniors who eventually are diabetics but unaware of the disease seems to be fairly high worldwide [12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

“…Although this group of authors understand that the laparoscopic approach for appendicitis treat-ment is the standard of care [15], many difficulties are found in our experience to perform all appendectomies by laparoscopy, such as laparoscopic materials and device availability, insurance approvals, surgeons' surgical skills, etc. Thus, 80% of appendectomies registered here were performed through laparotomies.…”

Section: Discussionmentioning

confidence: 99%

Acute appendicitis may no longer be a predominant disease of the young population

Pereira¹,

Mendes²,

Ruano³

et al. 2019

ait

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Background: Some authors consider acute appendicitis as the main cause of acute surgical abdomen. Incident in all ages, contemporary literature suggests that is more frequent in children and young adults, male predominantly. This study aims to test the hypothesis that the disease in question is no longer prevalent in young adults (excluding children) in the surveyed region.Methods: 1150 cases of emergency surgery were performed and prospectively analyzed. 300 cases of appendicitis in adults were selected and variables studied. Patients under 13 years old were excluded.Results: 190 patients older than 60 years had a diagnosis of acute appendicitis confirmed by biopsy. There is a predominance of males. The elderly population takes less time to seek medical assistance and has fewer complications, despite being more often admitted to the ICU due to other comorbidities. Conclusions:A trend regarding acute appendicitis epidemiology may exist. In the specific studied region acute appendicitis is no longer a disease prevalent in young adults. Surgeons and emergency physicians must be aware that acute appendicitis may no longer be predominantly common in young adults in their own specific region. Multicenter studies are needed to determine whether these data are reproduced in a geographical area of greater extent.

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“…(10) The actual role of parasitic infestation as a co-factors in appendicites is still open to debate. (1,3,6) It has been observed that enterobius vermicularis can cause pathological changes to the appendix, ranging from lymphoid hyperplesia to acute phlegmonous appendicitis, gangrenous appendicites and peritonitis. (4,12 ) Our study showed normal histology (n =48, 63.15%), followed by lymphoid hyperplasia (n=18, 23.6%) whereas only 08(10.52%) cases of enterobius vermicularis infestation had acute or acute suppurative appendicitis.…”

Section: Discussionmentioning

confidence: 99%

“…(1) The incidence of appendectomy is 12% for men and 25% for women and the lifetime risk of acute appendicitis is 8.6% and 6.7% for men and women, respectively. (2) Appendicitis is primarily a disease of adolescents and young adults with a peak incidence in the second and third decade of life.…”

Section: Introductionmentioning

confidence: 99%

Worm Infestation in Appendix - A Retrograde Study

Kumar¹,

Sinha²,

Kunal³

et al. 2015

jemds

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. METHODOLOGY: A retrospective analysis of histopathology reports of 1468 appendix specimen of patients of all age and gender who underwent appendectomy for acute appendicitis was done. Enterobius vermicularis was found to be most common worm present in the appendix followed by ascaris species. Detail histopathology reports of 76 cases with appendiceal enterobius vermicularis infestation were examined. Data were analyzed through IBM SPSS version 20. RESULTS: A total of 76 specimens of appendiceal enterobius vermicularis infestation among 1468 appendectomy cases produce a frequency of 5.17%. Mean age group of patients with appendiceal enterobius vermiculars infestation was 14.38±9.83 year with an overwhelming (50.76%) presenting in second decade of life. Male to female ratio was 1.24:1.Normal histology (n=48, 63.15%) was most frequently reported followed by lymphoid hyperplasia (n=18, 25%), whereas only 08(10.52%) cases of enterobius vermicular infestation had acute supportive appendicitis. CONCLUSIONS: Entrobius vermicular is the most common worm infestation in appendix and result in symptoms mimicking acute appendicitis without causing acute inflammation of the appendix. So it cannot be considered conclusively in the etiology of acute appendicitis. Antihelminthic therapy must be instituted for cases of entesobuis vermicular is infestation. KEYWORDS: Acute appendicitis, Histopathology, Appendiceal enterobius vermicularis, Parasitic infestations. INTRODUCTION:Acute appendicitis is the most frequently observed disease requiring emergency surgery. (1) The incidence of appendectomy is 12% for men and 25% for women and the lifetime risk of acute appendicitis is 8.6% and 6.7% for men and women, respectively. (2) Appendicitis is primarily a disease of adolescents and young adults with a peak incidence in the second and third decade of life. (3) A variety of neoplastic and inflammatory conditions can mimic acute appendicitis. Parasites are one of the most uncommon causes of acute appendicitis. Enterobius vermiculats, ascaris lumbricoids, schistosoma spcies and Taenia species are the parasites that can lead to a clinical picture of acute appendicites. Enterobius vermicularis is the parasite that most frequently contributes to a clinical picture of acute appendicitis. (4,5) Clinical diagnosis of acute appendicitis is routinely done on history especially of migratory pain and elicitation of physical signs. Out of reported 250,000 appendectomies performed worldwide annually, about 15% are carried out on non-appendiceal pathologies. (6) In literature these is a consensus on luminal obstruction being the most common cause of acute appendicitis. Luminal obstruction is mostly caused by fecal impactions and lymphoid hyperplasia. (3,7,8) Appendiceal parasitosis is almost never suspected or diagnosed pre-

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Acute appendicitis: position paper, WSES, 2013

Cited by 9 publications

References 34 publications

Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5,340 cases

Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5,340 cases

Acute appendicitis may no longer be a predominant disease of the young population

Worm Infestation in Appendix - A Retrograde Study

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