An assessment of the severity of recurrent appendicitis

Dixon, Matthew R.; Haukoos, Jason S.; Park, Ina U.; Oliak, David; Kumar, Ravin; Arnell, Tracey D.; Stamos, Michael J.

doi:10.1016/j.amjsurg.2003.08.016

Cited by 65 publications

(47 citation statements)

References 10 publications

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“…In the Third World patients frequently do not attend for an interval appendectomy if they have been pain free and asymptomatic. The recurrence rate is reported to be as low as 5-20% ( Tekin A 2008, Adala SA 1996 and importantly the recurrent disease is milder than the primary acute appendicitis (Dixon MR 2003). The effectiveness of the immediate conservative therapy is a proven and acceptable mode of treating the mass but the need of interval appendectomy is questioned and it may not be cost effective( Hung-Wen Lai 2005 ).…”

Section: Critics Of Conventional Treatmentmentioning

confidence: 99%

Recent Trends in the Treatment of the Appendicular Mass

Malik¹,

Shaikh²

2012

Appendicitis - A Collection of Essays From Around the World

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Section: Critics Of Conventional Treatmentmentioning

confidence: 99%

Recent Trends in the Treatment of the Appendicular Mass

Malik¹,

Shaikh²

2012

Appendicitis - A Collection of Essays From Around the World

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“…Recurrences can be managed by a repeat in conservative treatment or observation. Some authorities report that recurrences following conservative treatment tend to follow a milder course (40). It is recommended that appendicectomy should be reserved for multiple recurrences (more than 2) and for those who fail to improve.…”

Section: Interval Appendicectomymentioning

confidence: 99%

“…It is not surprising that the investigators who reported a higher recurrence rate following conservative treatment have advocated that this approach should be considered in patients with a high risk for post-operative complications. In a meta-analysis by Varadhan et 40 patients with a sonographic diagnosis of acute appendicitis were randomised to either appendicectomy or antibiotics only therapy (5). They concluded that patients who received nonsurgical treatment did as well as the patients who underwent an appendicectomy.…”

Section: Efficacymentioning

confidence: 99%

What Is the Role of Conservative Antibiotic Treatment in Early Appendicitis?

Chamisa¹

2012

Appendicitis - A Collection of Essays From Around the World

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“…Again, a definitive answer is not available, due to the lack of large-scale, prospective trials. Several authors suggest that this procedure is superfluous because the incidence of recurrent appendicitis in these patients is actually quite low, less than 20% [20,[23][24][25][26][27]. It has also been suggested that recurrent appendicitis, when it does occur, has a more benign presentation than when it was diagnosed originally [24,27].…”

Section: Complicated Intra-abdominal Infections S-55mentioning

confidence: 99%

“…Several authors suggest that this procedure is superfluous because the incidence of recurrent appendicitis in these patients is actually quite low, less than 20% [20,[23][24][25][26][27]. It has also been suggested that recurrent appendicitis, when it does occur, has a more benign presentation than when it was diagnosed originally [24,27]. Moreover, interval appendectomy has complications associated with its use [18,26,28].…”

Section: Complicated Intra-abdominal Infections S-55mentioning

confidence: 99%

Clinical Challenges and Unmet Needs in the Management of Complicated Intra-abdominal Infections

Mazuski

2005

Surgical Infections

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Methods: Based on a review of the literature, treatment guidelines, and expert opinion, the challenges of managing patients with complicated intra-abdominal infections are summarized using a patient stratification approach: "Lower risk" of treatment failure and death vs. "higher risk."Results: Risk factors for treatment failure and death can be grouped into several categories, including the patient's pre-existing medical comorbidities and physiological response to the infection, the extent of the intra-abdominal infection, and the presence of specific pathogenic microorganisms. These latter factors may be more useful than the Acute Physiology and Chronic Health Evaluation (APACHE) II score in evaluating specific management strategies for patients with complicated intra-abdominal infections. The principal goal of treatment in lower-risk patients is to avoid morbidity related to source control procedures and antimicrobial therapy. Limitation of the scope of source control procedures and utilization of short-duration, narrow-spectrum, low-toxicity antimicrobial regimens is advisable to avoid adverse drug reactions and selection of resistant organisms. For higher-risk patients, the goal is to develop improved management modalities, so that morbidity and mortality are reduced. The recommended approach for higher-risk patients is to identify the most appropriate source control procedure and antimicrobial therapy, as dictated by the patient's specific risk factors, and to utilize the optimal tools of critical care medicine to treat these critically ill, septic patients. The emergence of bacterial resistance also must be considered when selecting antimicrobial therapy for both low risk and high risk patients with intra-abdominal infections. Because aminoglycoside regimens are becoming less favored, and optimal therapeutic strategies have not been standardized, the use of new treatment options (e.g., tigecycline) may be valuable when managing patients with intra-abdominal infections. especially for resistant isolates.Conclusions: The management of lower-risk patients with intra-abdominal infections is distinct compared with patients at higher risk due to compromised physiological status, extent of intra-abdominal infection, or presence of nosocomial pathogens associated with higher-

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An assessment of the severity of recurrent appendicitis

Cited by 65 publications

References 10 publications

Recent Trends in the Treatment of the Appendicular Mass

Recent Trends in the Treatment of the Appendicular Mass

What Is the Role of Conservative Antibiotic Treatment in Early Appendicitis?

Clinical Challenges and Unmet Needs in the Management of Complicated Intra-abdominal Infections

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