Institutional review of patients presenting with suspected appendicitis

Teo, Andrew Teck Kwee; Lefter, Liviu P.; Zarrouk, Ali; Merrett, Neil D.

doi:10.1111/ans.12531

Cited by 12 publications

(10 citation statements)

References 24 publications

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“…A recent publication had a 27 % negative appendectomy rate and the authors justify their low threshold to operate by stating that it avoids perforation [ 73 ]. Others disagree and found that delaying surgical intervention did not put the patient at risk and may have actually improved patient outcomes [ 74 ].…”

Section: Resultsmentioning

confidence: 99%

WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis

Saverio¹,

et al. 2016

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Acute appendicitis (AA) is among the most common cause of acute abdominal pain. Diagnosis of AA is challenging; a variable combination of clinical signs and symptoms has been used together with laboratory findings in several scoring systems proposed for suggesting the probability of AA and the possible subsequent management pathway. The role of imaging in the diagnosis of AA is still debated, with variable use of US, CT and MRI in different settings worldwide. Up to date, comprehensive clinical guidelines for diagnosis and management of AA have never been issued. In July 2015, during the 3rd World Congress of the WSES, held in Jerusalem (Israel), a panel of experts including an Organizational Committee and Scientific Committee and Scientific Secretariat, participated to a Consensus Conference where eight panelists presented a number of statements developed for each of the eight main questions about diagnosis and management of AA. The statements were then voted, eventually modified and finally approved by the participants to The Consensus Conference and lately by the board of co-authors. The current paper is reporting the definitive Guidelines Statements on each of the following topics: 1) Diagnostic efficiency of clinical scoring systems, 2) Role of Imaging, 3) Non-operative treatment for uncomplicated appendicitis, 4) Timing of appendectomy and in-hospital delay, 5) Surgical treatment 6) Scoring systems for intra-operative grading of appendicitis and their clinical usefulness 7) Non-surgical treatment for complicated appendicitis: abscess or phlegmon 8) Pre-operative and post-operative antibiotics.

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Section: Resultsmentioning

confidence: 99%

WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis

Saverio¹,

et al. 2016

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“…In previous decades, a NAR between 15% and 25% has been accepted as reasonable . The published literature estimating the NAR in Australia is predominantly based upon single‐centre retrospective audits …”

Section: Discussionmentioning

confidence: 99%

“…Research in this area in Australia has predominantly been limited to single‐centre retrospective audits of individual institutions . Although single‐centre audits are important for quality improvement purposes for individual organizations, they can be difficult to apply in a broader sense and inform systemic policy and procedure guidelines.…”

Section: Introductionmentioning

confidence: 99%

Emergency appendicectomy in Australia: findings from a multicentre, prospective study

Arthur

Gartrell

Manoharan

et al. 2017

ANZ Journal of Surgery

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“…The incidence of disease in children aged birth to 4 years is about 1 to 2 cases per 10,000 children per year, reaching 25 cases per 10,000 children per year in older children [4]. The prevalence of disease in boys is twice that of girls with a brief distinction in different countries [5], [6]. The prevalence of acute appendicitis in developed countries is higher probably due to low fibre diet, genetic susceptibilities, as well as different patterns in gastrointestinal flora [7].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Potential Association of Platelet Levels, Mean Platelet Volume and Platelet Distribution Width with Acute Appendicitis

Sepas

Negahi

Mousavie

et al. 2019

Open Access Maced J Med Sci

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BACKGROUND: The occurrence and early management of acute appendicitis among children are especially important due to the difficult diagnosis and nonspecific symptoms of the disease. Diagnosis of appendicitis in children is very difficult due to similarity of its symptoms to other diseases, and also its self-limiting nature Platelet indexes such as mean platelet volume (MPV) and platelet distribution width (PDW) have been suggested as a biomarker of inflammation. AIM: Therefore, we examined the association of MPV and PDW with acute appendicitis in children. METHODS: This cross-sectional study was conducted on 464 patients with suspected acute appendicitis under the age of 18 years referred to the specialised hospitals of the ten studied provinces between October 2014 and October 2015. All data obtained regarding patient's lab tests, i.e. platelet count, MPV and PDW and also radiological studies and surgical reports were gathered in datasheets and analysed to evaluate the potential association of platelet levels, mean platelet volume (MPV) and platelet distribution width (PDW) with acute appendicitis RESULTS: Our results showed that the MPV was significantly higher in acute appendicitis in comparison to perforated appendicitis as well as acute gangrenous appendicitis. PDW was significantly higher in acute appendicitis in comparison to perforated appendicitis and acute gangrenous appendicitis. The current project indicated that PDW < 10.05 had a sensitivity of 35% and specificity of 75%, platelet count < 229500 had a sensitivity of 24% and specificity of 75% and MPV < 8.95 had a sensitivity of 70% and specificity of 71%. CONCLUSION: Our study suggested that platelet indexes such as MPV and PDW could significantly correlate with acute appendicitis in pediatric patients. Hence, we believe that both MPV and PDW could use as a simple and low-cost lab test for diagnosing acute appendicitis. Also, this study revealed that the MPV lower than 8.95 could be a novel index for diagnosing acute appendicitis with sensitivity of 70% and specificity of 71%.

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Institutional review of patients presenting with suspected appendicitis

Abstract: Elevated WCC, NC and CRP were all associated with acute appendicitis and SA in adults only. CT is useful for refining the diagnosis in adult females. A combination of inflammatory markers, ultrasound and AlvS may be used selectively to complement or maximize the advantages of CT.

Cited by 12 publications

References 24 publications

WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis

WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis

Emergency appendicectomy in Australia: findings from a multicentre, prospective study

Evaluation of the Potential Association of Platelet Levels, Mean Platelet Volume and Platelet Distribution Width with Acute Appendicitis

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