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Machine-learning-assisted Preoperative Prediction of Pediatric Appendicitis Severity.

J Pediatr Surg

January 2025

McGill University Faculty of Medicine and Health Sciences, Canada; Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Qc, Canada.

Purpose: This study evaluates the effectiveness of machine learning (ML) algorithms for improving the preoperative diagnosis of acute appendicitis in children, focusing on the accurate prediction of the severity of disease.

Methods: An anonymized clinical and operative dataset was retrieved from the medical records of children undergoing emergency appendectomy between 2014 and 2021. We developed an ML pipeline that pre-processed the dataset and developed algorithms to predict 5 appendicitis grades (1 - non-perforated, 2 - localized perforation, 3 - abscess, 4 - generalized peritonitis, and 5 - generalized peritonitis with abscess).

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Background: Colorectal cancer (CRC) stands as the third most prevalent malignancy globally and is recognized as the second leading cause of cancer-related mortality. Notably, nearly 50% of individuals diagnosed with CRC ultimately develop metastatic disease, with the peritoneum emerging as the second most frequent site for metastatic spread. Recent advancements in therapeutic frameworks have enhanced both survival rates and quality of life metrics for patients afflicted with colorectal cancer peritoneal metastases (CRCPM).

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Feline infectious peritonitis (FIP) is an infectious disease characterized by non-specific laboratory changes and clinical signs. Clinical symptoms include anorexia, jaundice, fever, and weight loss. Moreover, some lesions are found in the digestive and respiratory systems.

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This case report highlights the diagnostic challenges in distinguishing between metastatic peritoneal mesothelioma with duodenal involvement and synovial sarcoma of the duodenum, two rare and complex entities. A 59-year-old woman presented with nonspecific abdominal symptoms, and imaging revealed a heterogeneous lesion between the right hepatic lobe and duodenum. Endoscopic ultrasound-guided biopsy and subsequent histopathological analysis initially suggested synovial sarcoma, but further examination, including a FISH assay, confirmed the diagnosis of malignant peritoneal mesothelioma.

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Growing teratoma syndrome (GTS) is characterized by a reduction in serum tumor markers despite the growth of a benign mature teratomatous mass following chemotherapy for germ cell tumors. Gliomatosis peritonei (GP) typically accompanies ovarian teratomas, marked by the dissemination of mature glial tissue across the peritoneum. The concurrent presence of GTS and GP after treatment for ovarian immature teratoma (IMT) is notably rare, with approximately 20 reported cases.

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