Appendicitis Research Today is a free monthly online journal that collates and summarizes the latest research about Appendicitis, including details on symptoms, surgery, causes, treatment.

The Amount of Comorbidities as a Single Parameter Has No Effect in Predicting the Outcome in Appendicitis Patients Older than 60 Years.

Ibis C, Albayrak D, Hatipoglu AR, Turan N

From the Trakya University Medical Faculty, Department of General Surgery and Department of Biostatistics, Edirne, Turkey.

BACKGROUND:: Retrospective analysis of acute appendicitis patients older than 60 and statistical evaluation of the association between the accompanying illnesses, severity of peritonitis, morbidity, and mortality rates. INTRODUCTION:: Although acute appendicitis is not frequent among aged populations, accompanying comorbidities of the geriatric patients are always fear factors before an emergency abdominal surgery even for acute appendicitis. METHODS:: The data of the 27 patients older than 60 years who underwent appendectomy were retrospectively analyzed. The patients were grouped according to the total number of their comorbidities, Mannheim peritonitis index scores, and the period between the onset of abdominal pain and the admission to the hospital. RESULTS:: The mean age of the patients was 73 years. The morbidity and mortality rates were statistically significantly higher in perforated cases. The comparison of patients with </=1 comorbidity with patients with >/=2 comorbidities did not show any statistical difference in morbidity and mortality. The sensitivity, specifity, positive predictive value, and negative predictive values for mortality in geriatric acute appendicitis patients with Mannheim peritonitis index scores greater than 26 were found to be 75%, 86%, 50%, and 95%, respectively. DISCUSSION:: Retrospective evaluation of geriatric patients with acute appendicitis, according to the total number of their comorbidities, surprisingly revealed no statistical difference between groups. We thought that a high Mannheim peritonitis index score is a more reliable criteria than the total number of comorbidities in predicting the prognosis of patients with acute appendicitis in the geriatric population.

Published 5 February 2010 in South Med J.
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Articles on Appendicitis published 3 February 2010:

Abiotrophia/Granulicatella Tubo-ovarian Abscess in an Adolescent Virginal Female.   J Pediatr Adolesc Gynecol, 23(1): e9-e12.

Tubo-ovarian abscess (TOA) is a common acute complication of pelvic inflammatory disease (PID). It can also develop as a complication of pelvic or abdominal surgery, malignancy, and intra-abdominal processes such as appendicitis. In premenopausal women, PID is the most common cause of tubo-ovarian abscess. We report a case of tubo-ovarian abscess in a virginal adolescent female with no past surgical history and no known history of appendicitis, inflammatory bowel disease, or cancer. Cultures of ... [Abstract] [Full-text]

Articles on Appendicitis published 2 February 2010:

Evidence-based adjustment of antibiotic in pediatric complicated appendicitis in the era of antibiotic resistance.   Pediatr Surg Int, 26(2): 157-60.

INTRODUCTION: Antibiotic resistance is a global issue especially in developed areas. With the emergence of antibiotic resistant-bacteria, the traditional choice of broad spectrum antibiotics may not be effective in complicated appendicitis. We herein report the bacteriology and antibiotic susceptibility of intra-operative peritoneal culture in children with acute appendicitis in Hong Kong. This may guide us to adjust the choice of antibiotics with evidence. METHODS: A retrospective review of ... [Abstract] [Full-text]

Articles on Appendicitis published 1 February 2010:

Laparoscopic versus open appendectomy: a prospective randomized comparison.   Surg Endosc, 24(2): 266-9.

BACKGROUND: Whether laparoscopy offers a benefit over open surgery in the management of acute appendicitis or not remains a subject of controversy despite the publication of numerous randomized studies. This study aimed to compare laparoscopic appendectomy (LA) with open appendectomy (OA) and to ascertain its therapeutic benefit. METHODS: Adult patients older than 14 years presenting with signs and symptoms suggestive of acute appendicitis were randomized to undergo either LA or OA from January ... [Abstract] [Full-text]

Discovery and validation of urine markers of acute pediatric appendicitis using high-accuracy mass spectrometry.   Ann Emerg Med, 55(1): 62-70.e4.

STUDY OBJECTIVE: Molecular definition of disease has been changing all aspects of medical practice, from diagnosis and screening to understanding and treatment. Acute appendicitis is among many human conditions that are complicated by the heterogeneity of clinical presentation and shortage of diagnostic markers. Here, we sought to profile the urine of patients with appendicitis, with the goal of identifying new diagnostic markers. METHODS: Candidate markers were identified from the urine of ... [Abstract] [Full-text]

Laparoscopy: a safe approach to appendicitis during pregnancy.   Surg Endosc, 24(2): 383-9.

BACKGROUND: The aim of this study was to evaluate laparoscopic versus open surgery for suspected appendicitis during pregnancy. METHODS: A hospital-based retrospective review of 65 consecutive pregnant patients who underwent surgery for suspected appendicitis from 1999 to 2008 was performed. Significance was determined by Pearson's chi(2) test, Fisher's exact test, Mann-Whitney test, and Kruskal-Wallis test. RESULTS: Of the 65 patients, 48 cases were laparoscopic and 17 open. Use of the ... [Abstract] [Full-text]

Diagnostic accuracy of noncontrast computed tomography for appendicitis in adults: a systematic review.   Ann Emerg Med, 55(1): 51-59.e1.

STUDY OBJECTIVE: We seek to determine the diagnostic test characteristics of noncontrast computed tomography (CT) for appendicitis in the adult emergency department (ED) population. METHODS: We conducted a search of MEDLINE, EMBASE, the Cochrane Library, and the bibliographies of previous systematic reviews. Included studies assessed the diagnostic accuracy of noncontrast CT for acute appendicitis in adults by using the final diagnosis at surgery or follow-up at a minimum of 2 weeks as the ... [Abstract] [Full-text]

Differential expression of the TRAIL/TRAIL-receptor system in patients with inflammatory bowel disease.   Pathol Res Pract, 206(1): 43-50.

TNF-related apoptosis inducing-ligand (TRAIL) is a potent inducer of apoptosis and plays an important role in immune regulation. To explore the role of TRAIL in inflammatory bowel disease (IBD), we examined the expression of the TRAIL/TRAIL-receptor system in colonic resections from patients with ulcerative colitis and Crohn's disease in comparison to normal colon and appendicitis. TRAIL and TRAIL-receptor (TRAIL-R) expression was assessed in resections of normal colon, colon of IBD patients, ... [Abstract] [Full-text]

Profiles of US and CT imaging features with a high probability of appendicitis.   Eur Radiol.

OBJECTIVES: To identify and evaluate profiles of US and CT features associated with acute appendicitis. METHODS: Consecutive patients presenting with acute abdominal pain at the emergency department were invited to participate in this study. All patients underwent US and CT. Imaging features known to be associated with appendicitis, and an imaging diagnosis were prospectively recorded by two independent radiologists. A final diagnosis was assigned after 6 months. Associations between ... [Abstract] [Full-text]

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