Altersappendizitis

Sülberg, D.; Chromik, Ansgar M.; Kersting, S.; Meurer, Kirsten; Tannapfel, Andrea; Uhl, Waldemar; Mittelkötter, U.

doi:10.1007/s00104-009-1754-4

Cited by 14 publications

(9 citation statements)

References 24 publications

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“…However, both CRP and WBC may be less useful for making a decision as to the treatment [46]. The comparisons of CRP and WBC between the groups in this study were consistent with the results reported earlier, where CRP correlated best with the severity of appendicitis [23,47,48,49]. Even though CRP takes approximately 24 h to peak, it has been discussed as a marker indicating when surgery is the optimal choice of treatment [50].…”

Section: Discussionsupporting

confidence: 82%

Local and Systemic Expressions of MMP-9, TIMP-1 and PAI-1 in Patients Undergoing Surgery for Clinically Suspected Appendicitis

et al. 2012

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Background/Aims: To examine, compare and correlate the expressions of matrix metalloproteinase 9 (MMP-9), tissue inhibitor of metalloproteinase 1 (TIMP-1) and plasminogen activator inhibitor type 1 (PAI-1) in appendiceal tissue and pre- and postoperative blood samples in patients undergoing surgery for clinically suspected appendicitis. Methods: Fifty-seven patients with complete tissue and blood samples were included and divided into groups of noninflamed appendix/lymphadenitis (n = 7), phlegmonous appendicitis (n = 30), gangrenous appendicitis (n = 11) and perforated appendicitis (n = 9). The protein expressions were assessed with ELISAs. The local expressions of MMP-9, TIMP-1 and PAI-1 were correlated with the systemic expressions at the time of surgery while the systemic individual differences between surgery and recovery were compared. Results: There was a positive correlation between tissue and plasma PAI-1 (p < 0.05). The individual differences for plasma MMP-9 and PAI-1 were statistically nonsignificant, while they were higher for TIMP-1 in patients with perforated appendicitis compared with phlegmonous (p < 0.0001) and gangrenous appendicitis (p < 0.01). Conclusions: Plasma PAI-1 reflected the levels in appendiceal tissue at the time of surgery. Systemic TIMP-1 could have the potential of distinguishing perforated from nonperforated appendicitis.

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Section: Discussionsupporting

confidence: 82%

Local and Systemic Expressions of MMP-9, TIMP-1 and PAI-1 in Patients Undergoing Surgery for Clinically Suspected Appendicitis

et al. 2012

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“…According to some studies [13], a high CRP value in elderly patients with acute appendicitis, could be a suspect index for the existence of a perforation (AUC 0.811 with the cut-off of 101.9 mg/l). Shin et al showed, as the delta neutrophil index, that measures of the fraction of immature granulocytes in the circulation is the only independent marker that can significantly predict the presence of perforation in multiple regressions in elderly patients [36].…”

Section: Have Laboratory Tests Sufficient Diagnostic Accuracymentioning

confidence: 99%

“…12 Department of Emergency Medicine, Morgagni-Pierantoni Hospital, Forlì, Italy. 13 Department of Biochemical Sciences and Human Oncology, University of Medical School "A. Moro" of Bari, Bari, Italy. 14 General and Oncological Surgery, Filippo Neri Hospital, Rome, Italy.…”

Section: Availability Of Data and Materials Not Applicablementioning

confidence: 99%

“…Furthermore, according to almost all authors, elderly patients were significantly more likely than other age groups to have complicated appendicitis with perforation or abscess. The complicated appendicitis rate ranges from 18 to 70% [2,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] (compared to a rate ranging from 3 to 29% among patients younger than 65 years old). The reason for this high risk of perforation could be the vascular sclerosis that the vermiform appendix develops in elderly patients and the narrowing of the lumen by fibrosis.…”

Section: Introductionmentioning

confidence: 99%

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The SIFIPAC/WSES/SICG/SIMEU guidelines for diagnosis and treatment of acute appendicitis in the elderly (2019 edition)

et al. 2020

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The epidemiology and the outcomes of acute appendicitis in elderly patients are very different from the younger population. Elderly patients with acute appendicitis showed higher mortality, higher perforation rate, lower diagnostic accuracy, longer delay from symptoms onset and admission, higher postoperative complication rate and higher risk of colonic and appendiceal cancer. The aim of the present work was to investigate age-related factors that could influence a different approach, compared to the 2016 WSES Jerusalem guidelines on general population, in terms of diagnosis and management of elderly patient with acute appendicitis. During the XXIX National Congress of the Italian Society of Surgical Pathophysiology (SIFIPAC) held in Cesena (Italy) in May 2019, in collaboration with the Italian Society of Geriatric Surgery (SICG), the World Society of Emergency Surgery (WSES) and the Italian Society of Emergency Medicine (SIMEU), a panel of experts participated to a Consensus Conference where eight panelists presented a number of statements, which were developed for each of the four topics about diagnosis and management of acute appendicitis in elderly patients, formulated according to the GRADE system. The statements were then voted, eventually modified and finally approved by the participants to the Consensus Conference. The current paper is reporting the definitive guidelines statements on each of the following topics: diagnosis, non-operative management, operative management and antibiotic therapy.

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“…Laboratory data show that serum levels of the white blood cell (WBC), C-reactive protein (CRP), and interleukin-6 are related to AA[ 44 - 46 ]. The most reliable marker is neither the neutrophil count nor CRP, but the WBC count[ 1 , 44 ].…”

Section: Diagnostic Valuementioning

confidence: 99%

Laparoscopic appendectomy for acute appendicitis: How to discourage surgeons using inadequate therapy

Hori¹,

Machimoto²,

Kadokawa³

et al. 2017

WJG

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Acute appendicitis (AA) develops in a progressive and irreversible manner, even if the clinical course of AA can be temporarily modified by intentional medications. Reliable and real-time diagnosis of AA can be made based on findings of the white blood cell count and enhanced computed tomography. Emergent laparoscopic appendectomy (LA) is considered as the first therapeutic choice for AA. Interval/delayed appendectomy at 6-12 wk after disease onset is considered as unsafe with a high recurrent rate during the waiting time. However, this technique may have some advantages for avoiding unnecessary extended resection in patients with an appendiceal mass. Non-operative management of AA may be tolerated only in children. Postoperative complications increase according to the patient’s factors, and temporal avoidance of emergent general anesthesia may be beneficial for high-risk patients. The surgeon’s skill and cooperation of the hospital are important for successful LA. Delaying appendectomy for less than 24 h from diagnosis is safe. Additionally, a semi-elective manner (i.e., LA within 24 h after onset of symptoms) may be paradoxically acceptable, according to the factors of the patient, physician, and institution. Prompt LA is mandatory for AA. Fortunately, the Japanese government uses a universal health insurance system, which covers LA.

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Altersappendizitis

Abstract: The CRP value showed a strong correlation with respect to the grade of inflammation and perforation. In conclusion, elderly patients with symptoms of appendicitis and a CRP value higher than 102 mg/l should undergo early diagnostic laparoscopy.

Cited by 14 publications

References 24 publications

Local and Systemic Expressions of MMP-9, TIMP-1 and PAI-1 in Patients Undergoing Surgery for Clinically Suspected Appendicitis

Local and Systemic Expressions of MMP-9, TIMP-1 and PAI-1 in Patients Undergoing Surgery for Clinically Suspected Appendicitis

The SIFIPAC/WSES/SICG/SIMEU guidelines for diagnosis and treatment of acute appendicitis in the elderly (2019 edition)

Laparoscopic appendectomy for acute appendicitis: How to discourage surgeons using inadequate therapy

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