Outpatient interval appendectomy after perforated appendicitis.

Background: Interval appendectomy may be advisable after successful nonoperative treatment of perforated appendicitis. To reduce the perceived morbidity of interval appendectomy, we sought to determine if the operation could be done on an outpatient basis. This study is focused on patient comfort and safety after laparoscopic interval appendectomy (LIA).

Early decisions in perforated appendicitis in children: lessons from a study of nonoperative management.

Background: In nonoperative management of perforated appendicitis, some children do not respond to treatment. This study sought early identifiers of failure to help in surgical decision making.

Methods: Fifty-eight patients with computed tomographic (CT)-proven perforated appendicitis were treated according to a nonoperative protocol.

Appendicitis and malrotation.

A 13-year-old child was admitted with abdominal pain suggesting acute appendicitis, but with some atypical findings. A computed tomography scan showed an inflamed appendix and fecalith in the central abdomen, and malrotation. These striking images both established the diagnoses and were useful in planning the operative approach.

Laparoscopic excision of a gastric diverticulum in a child.

Gastric diverticulum is a rare entity; the patient usually presents with vague abdominal pain, nausea, vomiting, and weight loss. Diverticulectomy is required for patients with intractable symptoms or complications. We report the laparoscopic excision of a gastric diverticulum in a 15-year-old girl who had been symptomatic for 5 years.

Nonoperative management of perforated appendicitis in children: can CT predict outcome?

Background: The optimal treatment of perforated appendicitis remains controversial, but there is a trend toward nonoperative management. CT scanning might be helpful in determining which patients could benefit from this treatment option.

Objective: To determine the value of CT imaging in predicting clinical success or failure in children with nonoperative management of perforated appendicitis.

Nontraumatic compartment syndrome of the extremities in children.

Acute compartment syndrome of an extremity poses a threat to both life and limb. The usual cause in children is trauma, especially fractures and burns. Two recent cases of nontraumatic compartment syndrome of the extremities in children are presented, both owing to infection followed by myositis or fasciitis.