Clinical Practice Guidelines for Pediatric Complicated Appendicitis

Farmer, Diana L.

doi:10.1001/jamasurg.2016.0193

Cited by 2 publications

(4 citation statements)

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“…Ethiopia, India, and Nigeria were among the areas with the greatest increases in the increases prevalence rate between 1990 and 2019 [5]. Luminal obstruction is thought to represent the main pathogenic event in the majority of patients with acute appendicitis [6]. Fecaliths, lymphoid hyperplasia, foreign things, parasites, and primary and metastatic tumors (carcinoid, adenocarcinoma, Kaposi sarcoma, and lymphoma) are a few possible causes [7].…”

Section: Overview and Pathophysiology Of Appendicitismentioning

confidence: 99%

Clinical Implications of Serum Bilirubin and Procalcitonin in the Diagnosis of Acute Appendicitis

Buhendwa,

Isaac,

Hidalgo

et al. 2024

IDOSR-JAS

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Acute appendicitis remains a common surgical emergency with challenges in prompt and accurate diagnosis. Serum biomarkers have garnered attention for their potential role in aiding diagnostic accuracy. This paper aims to update the clinical implications of serum bilirubin and procalcitonin levels in diagnosing acute appendicitis. A systematic review of literature was conducted, encompassing studies that investigated the relationship between serum bilirubin and procalcitonin levels and acute appendicitis. The search strategy included electronic databases, resulting in a comprehensive analysis of relevant articles. The findings suggest a notable association between elevated serum bilirubin levels and the presence of acute appendicitis. Furthermore, procalcitonin exhibited promising diagnostic potential, demonstrating a significant correlation with the severity of appendicitis. Subgroup analyses revealed varied sensitivity and specificity values, indicating the need for further refinement in clinical application. The integration of serum biomarkers, specifically bilirubin and procalcitonin, into the diagnostic algorithms of acute appendicitis could potentially enhance the accuracy of clinical assessments. However, limitations in existing studies, such as heterogeneity in patient populations and differing assay methodologies, emphasize the necessity for standardized protocols and larger prospective trials. In conclusion, serum bilirubin and procalcitonin levels show promise as adjunctive tools in diagnosing acute appendicitis. Their incorporation into clinical practice warrants careful consideration and validation through larger-scale studies to delineate their precise diagnostic utility, thereby potentially optimizing patient care pathways in the context of this prevalent surgical condition. Keywords : Acute appendicitis, Bilirubin, Procalcitonin, Diagnosis, Clinical implications

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Section: Overview and Pathophysiology Of Appendicitismentioning

confidence: 99%

Clinical Implications of Serum Bilirubin and Procalcitonin in the Diagnosis of Acute Appendicitis

Buhendwa,

Isaac,

Hidalgo

et al. 2024

IDOSR-JAS

View full text Add to dashboard Cite

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“…The latter is believed to be due to luminal obstruction which may result from a variety of causes, i.e. fecalith, lymphoid hyperplasia, foreign bodies and parasite meanwhile bacterial infection is believed to be central to appendix inflammation [8]. Several reports confirmed the importance of bacteria particularly Escherichia coli, Clostridium perfringens and Bacteroides sp.…”

Section: Introductionmentioning

confidence: 99%

“…For over 100 years of study, yet there is no single explanation for all causes of appendicitis; however, there are a few hypotheses i.e. classic hypothesis, which postulates that the obstruction of appendiceal lumen by either a fecalith or lymphoid hyperplasia (11-52%) [19], and it is believed to be a primary pathogenic event in most patients with acute appendicitis [8]. Lymphoid hyperplasia, with an unknown cause, has been suggested to be the underlying cause of purulent appendicitis at the absence of fecalith.…”

Section: Introductionmentioning

confidence: 99%

“…The mechanism of occurrence accompany obstruction and continuous mucus secretion lead to increased intraluminal pressure which can reach 50-65 mm/Hg but once luminal pressure exceeds 85 mm/Hg, thrombosis of the venules that drain the appendix starts cause arteriolar inflow, vascular congestion and engorgement of the appendix which become manifest leading to lymphatic and venous drainages are impaired and ischemia develops [8]. Mucosa becomes hypoxic and begins to ulcerate, resulting in a compromise of the mucosal barrier, leading to invasion of the appendiceal wall by intraluminal bacteria.…”

Section: Introductionmentioning

confidence: 99%

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Does expression of substance-P in normal appendices confirm the neuroimmune appendicitis or disprove the negative appendectomy?

2023

JPTCP

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Introduction: Detection of specific histological alteration in appendices was carried out using immunohistochemical technique involved using antibodies against a neuropeptide substance-P (s-P). Methods: Fifty patients aged 3-45 years (21 male and 29 female) admitted to Azadi Teaching Hospital, Kerkuk province, Iraq with clear clinical symptoms of appendicitis. Results: Significant differences (p≤0.034) was detected at age 11-15 and 16-30 years of patients with clinical suspected appendicitis (CSA) in most patients while right iliac fossa pain (RIFP), vomiting and nausea were predominate clinical symptoms yet non-specific signs of appendicitis. Only 82% appendices appeared inflamed and 18% were normal (without inflammation), were considered as experimental cases. The intensity and location of the s-P expression was classified as either no expression (negative s-P), weak (+) or strong (++). In experimental cases it was strongly expressed in nerve plexus than in acute inflammation of epithelium and muscularis layers while in lamina propria the expression was almost the same between the two groups. The normal appendices with symptoms were found without inflammation yet s-P expression was detectable. Conclusion: Therefore, the stronger expression of s-P in normal appendices may confirm the concept of neuroimmune appendicitis which disproves the negative term of "appendectomy". Further immunehistochemical studies are on to explore specific histological alteration associated with the pains using other antibodies i.e. vasoactive intestinal polypeptide (VIP) and GAP-43.

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Clinical Practice Guidelines for Pediatric Complicated Appendicitis

Cited by 2 publications

References 1 publication

Clinical Implications of Serum Bilirubin and Procalcitonin in the Diagnosis of Acute Appendicitis

Clinical Implications of Serum Bilirubin and Procalcitonin in the Diagnosis of Acute Appendicitis

Does expression of substance-P in normal appendices confirm the neuroimmune appendicitis or disprove the negative appendectomy?

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