Purpose: The treatment strategies for acute appendicitis differ depending on the facility, and various studies have investigated the usefulness of conservative treatment with antibiotics, laparoscopic surgery, and interval appendectomy (IA). However, although laparoscopic surgery is widely used, the clinical strategy for acute appendicitis, especially complicated cases, remains controversial. We assessed a laparoscopic surgery-based treatment strategy for all patients diagnosed with appendicitis, including those with complicated appendicitis (CA).
Methods: We retrospectively analysed patients with acute appendicitis treated in our institution between January 2013 and December 2021. Patients were classified into uncomplicated appendicitis (UA) and CA groups based on computed tomography (CT) findings on the first visit, and the treatment course was subsequently compared.
Results: Of 305 participants, 218 were diagnosed with UA and 87 with CA, with surgery performed in 159 cases. Laparoscopic surgery was attempted in 153 cases and had a completion rate of 94.8% (145/153). All open laparotomy transition cases (n = 8) were emergency CA surgery cases. No significant differences were found in the incidence of postoperative complications in successful emergency laparoscopic surgeries. In univariate and multivariate analyses for the conversion to open laparotomy in CA, only the number of days from onset to surgery ≥ 6 days was an independent risk factor (odds ratio: 11.80; P < 0.01).
Conclusion: Laparoscopic surgery is preferred in all appendicitis cases, including CA. Since laparoscopic surgery is difficult for CA when several days from the onset have passed, it is necessary that surgeons make an early decision on whether to operate.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10265908 | PMC |
http://dx.doi.org/10.1186/s12893-023-02070-y | DOI Listing |
BMJ Case Rep
January 2025
Radiology Department, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad and Tobago.
Amyand hernias are unusual inguinal hernias that contain the vermiform appendix. Rarely, an Amyand hernia can be complicated by acute appendicitis and present a diagnostic dilemma. Herein, we present the case of a complicated Amyand hernia that was initially diagnosed as an incarcerated inguinal hernia.
View Article and Find Full Text PDFInt J Surg Case Rep
January 2025
Department of General Surgery, Kamanga Medics Hospital, P.O. Box 5228, Mwanza, Tanzania.
Introduction: Appendicitis in pregnancy is the most common non-obstetric surgical condition which requires urgent evaluation and immediate intervention in a multidisciplinary approach. Pregnancy anatomical and physiological changes can mask the presentation of appendicitis and poses both diagnostic and management challenges.
Case Presentation: A 32 year old female, G3P2L2 at gestation age of 11 weeks by USS, presented with recurrent episodes of acute abdominal pain for one day, afebrile but accompanied with poor appetite, nausea and vomiting along episodes of per vaginal spotting which started three days prior.
Int J Surg Case Rep
January 2025
Ranga Hospital, Coimbatore, India.
Introduction: Isolated fallopian tube torsion (IFTT) is an exceedingly rare but serious cause of acute abdominal pain, especially in pediatric patients, with a reported prevalence of 1 in 1.5 million women. It occurs when the fallopian tube twists around its own axis, leading to venous and lymphatic obstruction, ischemia, and potential necrosis, without involving the ipsilateral ovary.
View Article and Find Full Text PDFJ Med Case Rep
January 2025
Dept. of General Surgery, Fortis Hospital, Sector 62, Noida, UP, 201309, India.
Introduction: Amyand's hernia, an uncommon condition characterized by the presence of the appendix within an inguinal hernial sac (< 1% incidence), poses diagnostic and therapeutic challenges. Often it is an intraoperative finding, with almost no clinical symptoms.
Case Presentation: This is a case of an Indian male in his early 80 years, diagnosed with bilateral direct inguinal hernias, one of which contained a noninflamed appendix.
Pediatr Surg Int
January 2025
Department of Pediatric Surgery, University of Health Sciences İzmir City Hospital, Bayrakli, 35540, Izmir, Turkey.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!