How to improve the clinical diagnosis of acute appendicitis in resource limited settings

A, Alvarado Durán

doi:10.1186/s13017-016-0071-8

Cited by 33 publications

(37 citation statements)

References 26 publications

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“…Diagnosis of acute appendicitis is a dynamic process that closely correlated with the pathological changes of the disease. Under resource limited conditions, sophisticatedly and fully considering of clinical symptoms, signs and blood biomarkers could potentially help medical practitioners in decisionmaking for acute appendicitis patients [32]. And the biomarkers of blood in ammation are of great value in the diagnosis and pathological classi cation of acute appendicitis [20,21,33].…”

Section: Discussionmentioning

confidence: 99%

Preoperative prediction of complicated appendicitis using machine learning method

Kang¹,

Li²,

Chi³

et al. 2020

Preprint

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BACKGROUND Accurate preoperative prediction of complicated appendicitis (CA) could help selecting optimal treatment and reducing risks of postoperative complications. The study aimed to develop a machine learning model based on clinical symptoms and laboratory data for preoperatively predicting CA.METHODS 136 patients with clinicopathological diagnosis of acute appendicitis were retrospectively included in the study. The dataset was randomly divided (94: 42) into training and testing set. Predictive models using individual and combined selected clinical and laboratory data features were built separately. Three combined models were constructed using logistic regression (LR), support vector machine (SVM) and random forest (RF) algorithms. The CA prediction performance was evaluated with Receiver Operating Characteristic (ROC) analysis, using the area under the curve (AUC), sensitivity, specificity and accuracy factors.RESULTS The features of the abdominal pain time, nausea and vomiting, the highest temperature, high sensitivity-CRP (hs-CRP) and procalcitonin (PCT) had significant differences in the CA prediction (P<0.001). The ability to predict CA by individual feature was low (AUC<0.8). The prediction by combined features was significantly improved. The AUC of the three models (LR, SVM and RF) in the training set and the testing set were 0.805, 0.888, 0.908 and 0.794, 0.895, 0.761, respectively. The SVM-based model showed a better performance for CA prediction. RF had a higher AUC in the training set, but its poor efficiency in the testing set indicated a poor generalization ability.CONCLUSIONS The SVM machine learning model applying clinical and laboratory data can well predict CA preoperatively which could assist diagnosis in resource limited settings.

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Section: Discussionmentioning

confidence: 99%

Preoperative prediction of complicated appendicitis using machine learning method

Kang¹,

Li²,

Chi³

et al. 2020

Preprint

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“…8 In practice, there are a number of clinical signs that indicate acute appendicitis: obturator sign, psoas sign, Rovsing's sign, Blumberg's sign, Markle's sign. [9][10][11] However, these clinical signs are encountered in a minority of patients. The typical signs of acute appendicitis are: generalized abdominal pain, more intense in the umbilical region, inappetence, nausea, vomiting, leukocytosis and fever.…”

Section: Discussionmentioning

confidence: 99%

Uncommon Differential Diagnosis of Acute Right-sided Abdominal Pain – Case Report

Kwizera

Wagner

et al. 2019

Journal of Interdisciplinary Medicine

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The appendix is a worm-like, blind-ending tube, with its base on the caecum and its tip in multiple locations. Against all odds, it plays a key role in the digestive immune system and appendectomy should therefore be cautiously considered and indicated. We report the case of a 45-year-old male with a known history of Fragile-X syndrome who presented to the emergency department with intense abdominal pain and was suspected of acute appendicitis, after a positive Dieulafoy’s triad was confirmed. The laparoscopic exploration showed no signs of inflammation of the appendix; nonetheless, its removal was carried out. Rising inflammatory laboratory parameters led to a focused identification of a pleural empyema due to a tooth inlay aspiration. Our objective is to emphasize the importance of a thorough anamnesis, even in cases of mentally impaired patients, as well as to highlight a rare differential diagnosis for appendicitis. Acute appendicitis is an emergency condition that requires a thorough assessment and appropriate therapy. Clinical examinations are important, but in this particular case, imaging methods had a much more important role in establishing the right treatment approach. Furthermore, the signs of acute appendicitis are mimicked by several medical conditions including respiratory tract infections.

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“…Diagnosing acute appendicitis can be challenging, as the typical clinical history and signs are not always present in 30–40% of cases. [5] Additionally, making a diagnosis can be more challenging in some groups of patients, including elderly individuals, which contributes to a delayed diagnosis and complicated onset. [3] , [5] …”

Section: Introductionmentioning

confidence: 99%

“…Many clinical evaluations, such as the Alvarado score, [5] and further imaging examinations, such as ultrasonography, computed tomography (CT), and magnetic resonance imaging, are used to increase the diagnostic accuracy; however, in some patients, the diagnosis can only be made postoperatively.…”

Section: Introductionmentioning

confidence: 99%

Complicated acute appendicitis presenting as an abscess in the abdominal wall in an elderly patient: A case report

Souza

Nunes²,

Massuqueto

et al. 2017

International Journal of Surgery Case Reports

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How to improve the clinical diagnosis of acute appendicitis in resource limited settings

Cited by 33 publications

References 26 publications

Preoperative prediction of complicated appendicitis using machine learning method

Preoperative prediction of complicated appendicitis using machine learning method

Uncommon Differential Diagnosis of Acute Right-sided Abdominal Pain – Case Report

Complicated acute appendicitis presenting as an abscess in the abdominal wall in an elderly patient: A case report

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