Early Uncomplicated Appendicitis-Who Can We Treat Nonoperatively?

This study evaluated nonoperative treatment for mild appendicitis and reviewed selection criteria to be used in introducing this option into clinical practice. A retrospective review of 73 consecutive cases of appendicitis treated by a single surgeon from 2011 to 2013 was completed. Patients who were diagnosed with mild appendicitis meeting the criteria of an APPENDICITIS scoring algorithm proposed in this manuscript were considered for nonoperative management.

Metastatic renal cell carcinoma to the thyroid gland.

Objective: To examine the presentation, diagnosis, and appropriate management of renal clear cell carcinoma metastasis to the thyroid gland.

Methods: We describe a clinical case of solitary thyroid metastasis from renal clear cell carcinoma and present a comprehensive review of the related English-language literature. Common patterns of presentation and generalized overall management recommendations are evaluated and summarized.

Does preoperative rofecoxib (Vioxx) decrease postoperative pain with laparoscopic cholecystectomy?

Background: A prospective, randomized, double-blinded clinical trial was designed to study the effects of preemptive rofecoxib (Vioxx) analgesia in patients undergoing elective laparoscopic cholecystectomy.

Methods: One hundred-twenty patients were enrolled in the study over a 21-month period, and 116 completed the study. One half of the patients received 50 mg rofecoxib preoperatively and the other half, placebo.

Ileal pouch perforation in pregnancy: report of a case and review of the literature.

Acute abdominal pain, especially in the presence of free intra-abdominal air, in a pregnant patient who has previously undergone ileal pouch-anal anastomosis may be a result of acute perforation of the pouch. The case of a 30-year-old multigravida with an uncomplicated pregnancy at 27 weeks gestation who was admitted to the perinatal ward for preterm labor is described. The patient's past medical history was significant for an ileal pouch-anal anastomosis for ulcerative colitis.

What have we learned over the past 20 years about appendicitis in the elderly?

Background: This study evaluates appendicitis in the elderly, comparing our findings to those previously published a decade earlier.

Methods: Comparison of appendicitis in the elderly (aged 60 years and older) from 1978 to 1988 with the following 10 years, 1988 to 1998.

Results: Overall (1978-1998) 26% of patients presented typically, one third delayed seeking care, with only half diagnosed correctly on admission.