Analysis of predictive factors for perforated appendicitis in children

Miyauchi, Harunori; Okata, Yuichi; Hatakeyama, Tadashi; Nakatani, Taichi; Nakai, Yumiko; Bitoh, Yuko

doi:10.1111/ped.14148

Cited by 21 publications

(32 citation statements)

References 12 publications

(19 reference statements)

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“…Typically, a combination of labs, imaging, symptoms, and perforation status helps dictate the treatment pathway. Some predictive factors for perforated appendicitis include pain longer than two days' duration, fever, elevated C-reactive protein level, and presence of an appendicolith 10 . Delays in presentation may affect those predictive factors, primarily the duration of pain.…”

Section: Techniques Have Evolved From Traditional Open Approaches To Various Laparoscopic Techniquesmentioning

confidence: 99%

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Perforated Appendicitis During a Pandemic: The Downstream Effect of COVID-19 in Children

Esparaz

Chen

Beierle

et al. 2021

Journal of Surgical Research

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Techniques Have Evolved From Traditional Open Approaches To Various Laparoscopic Techniquesmentioning

confidence: 99%

“…With these new sets of challenges, concerns arose about delays in presentation to the hospital contributing to more advanced disease. Specifically, for appendicitis, a delay in presentation has been linked to perforation 10 .…”

Section: Techniques Have Evolved From Traditional Open Approaches To Various Laparoscopic Techniquesmentioning

confidence: 99%

Perforated Appendicitis During a Pandemic: The Downstream Effect of COVID-19 in Children

Esparaz

Chen

Beierle

et al. 2021

Journal of Surgical Research

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“…However, recent evidence suggests that these scores may have the potential to achieve acceptable levels of therapeutic accuracy. 21 Recently, Hao et al 22 evaluated the diagnostic value of US combined with PAS for differentiation between SAA and complicated acute appendicitis (CAA) in children. They found that using PAS solely to distinguish between the entities provided sensitivity of 76.5% and specificity of 84.1%, and combining US results with the score provided sensitivity of 17.6% and specificity of 98.8%.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Alvarado Score and Pediatric Appendicitis Score in the Success of Nonoperative Management for Simple Acute Appendicitis in Children

et al. 2020

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Introduction During the past decade, nonoperative management (NOM) for simple acute appendicitis (SAA) in children has been proven safe with noninferior complications rate. The aim of this study was to examine Alvarado score and pediatric appendicitis score (PAS) together with other factors in predicting failure of NOM in children presenting with SAA. Materials and Methods Patients aged 5 to 18 years admitted to our department between 2017 and 2019 diagnosed with SAA were given a choice between surgical management and NOM. We divided the NOM patients into two groups: successful treatment and failed NOM, comparing their files for Alvarado score and PAS and other clinical and demographic factors, with a mean follow-up of 7 months. Failure was determined as need for appendectomy following conservative treatment due to any reason. Results A total of 85 patients answered criteria and chose NOM. Overall failure rate was 32.9%. We found no difference in the mean Alvarado score and PAS as well as in each component of both scores between success and failed NOM groups. However, when using the risk classification of the scores, we found a significant correlation between high-risk Alvarado score and failed NOM. After adjusting for age, gender, duration of symptoms, diagnosis of tip appendicitis, and presence of appendicolith, the odds of failure were four times higher among high-risk Alvarado group. Conclusion Alvarado score of 7 or higher, older age, and diagnosis of an appendicolith on imaging are possible predictors for failure of NOM for SAA in children.

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“…Appendicitis with fecalith(s) is often encountered in clinical practice. The ratio of appendicitis cases with fecalith has been reported in different studies [1][2][3][4], some of which have reported an association between the appendix and fecalith formation, and that fecalith formation is associated with perforation in cases of acute appendicitis and the failure of conservative treatment [5][6][7]. Others have demonstrated that fecaliths do not influence gangrenous or perforated appendicitis [3].…”

Section: Introductionmentioning

confidence: 98%

Appendicitis with submucosal fecalith mimicking a submucosal tumor: a case report

et al. 2021

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Background Submucosal fecalith(s) mimicking submucosal tumors of the gastrointestinal lumen are rare. Moreover, accurate preoperative diagnosis of these entities is exceedingly difficult, and the mechanism(s) of their formation remains unclear. Case presentation A 40-year-old woman visited the authors’ hospital due to lower abdominal pain and diarrhea. She had previously been treated for endometriosis. Laboratory investigation revealed increased C-reactive protein levels. Abdominal contrast-enhanced computed tomography revealed thickening of the appendix wall and dilation of the small intestine. The patient was diagnosed with paralytic ileus caused by appendicitis, and interval appendectomy was scheduled. She underwent laparoscopic-assisted appendectomy after conservative treatment. Partial cecal resection was selected due to the presence of an elastic mass in the cecum. The final pathological diagnosis was submucosal fecalith, not submucosal tumor. On day 5, the patient was discharged without any postoperative complications. Conclusions In cases of appendicitis with fecalith(s) that appear as submucosal tumor(s) on colonoscopy, submucosal fecalith mimicking submucosal tumor should be considered in the differential diagnosis.

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Analysis of predictive factors for perforated appendicitis in children

Abstract: This article may be used for noncommercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

Cited by 21 publications

References 12 publications

Perforated Appendicitis During a Pandemic: The Downstream Effect of COVID-19 in Children

Perforated Appendicitis During a Pandemic: The Downstream Effect of COVID-19 in Children

Predictive Value of Alvarado Score and Pediatric Appendicitis Score in the Success of Nonoperative Management for Simple Acute Appendicitis in Children

Appendicitis with submucosal fecalith mimicking a submucosal tumor: a case report

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