scholarly journals Utility of the immature granulocyte percentage for diagnosing acute appendicitis among clinically suspected appendicitis in adult

2018 ◽  
Vol 32 (7) ◽  
pp. e22458 ◽  
Author(s):  
Jae-Sang Park ◽  
June-Sung Kim ◽  
Youn-Jung Kim ◽  
Won Young Kim
Keyword(s):  
Acute Appendicitis ◽  
Suspected Appendicitis ◽  
Immature Granulocyte

EP.FRI.615 Assessing the reliability of the Adult Appendicitis Score in managing patients with suspected acute appendicitis

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Carry Zheng ◽  
Shiela Lee ◽  
Steven Brown ◽  
Venkat Kanakala
Keyword(s):  
Acute Appendicitis ◽  
Risk Group ◽  
Pathological Finding ◽  
High Risk Group ◽  
Histological Diagnosis ◽  
Suspected Appendicitis ◽  
Tertiary Centre ◽  
Negative Appendicectomy ◽  
Age Range ◽  
Suspected Acute Appendicitis

Abstract Aims To evaluate the effectiveness of using a clinical prediction tool in the management of suspected acute appendicitis Methods Retrospective data was collected on patients undergoing appendicectomy at a single tertiary centre from November 2019 to June 2020. Inclusion criteria were all patients aged 18 and above undergoing diagnostic laparoscopy for suspected appendicitis. Exclusion criteria were all patients that had a pathological finding other than appendicitis at laparoscopy. The pre operative AAS score at first presentation was calculated and patients grouped into low(0-10), intermediate(11-15), and high(16 and above) risk. These groups were then compared to the histological findings. Results A total of 74 patients were included, 44 male and 30 female. The age range was from 18 to 83, with a median age of 36. Of 10 patients in the low risk group, 4 (40%) had appendicitis on histology. 36 out of 40 (90%) patients in the intermediate risk group had appendicitis and 100% of the 24 patients in the high risk group. Pearson’s coefficient showed a significant correlation between the AAS risk (low, intermediate, and high) and the histological diagnosis of appendicitis (r = 0.48, p = 0.000016). Conclusions Our study did show a positive correlation between the AAS risk stratification and histological diagnosis. Based on our findings we would recommend the adoption of this score in assessing patients with suspected acute appendicitis and minimising the negative appendicectomy rate.

scholarly journals Evaluation of diagnostic value of neutrophil to lymphocyte ratio in younger and older pediatrics suspect to acute appendicitis in Imam Hossein hospital

2020 ◽  
Vol 5 (2) ◽  
pp. e26-e26
Author(s):  
Azar Baradaran ◽  
Azar Naimi ◽  
Elahe Pirpiran ◽  
Masoud Akhlaghi
Keyword(s):  
Acute Appendicitis ◽  
Sensitivity And Specificity ◽  
Medical Center ◽  
Statistical Tests ◽  
The United States ◽  
Diagnostic Value ◽  
Neutrophil To Lymphocyte Ratio ◽  
Significance Level ◽  
Suspected Appendicitis ◽  
Lymphocyte Ratio

Introduction: Acute appendicitis in children is the most common acute surgical condition in children. Each year, 80000 children in the United States suffer from appendicitis. Objectives: The aim of this study was to evaluate diagnostic value of neutrophil to lymphocyte ratio (NLR) in younger and older pediatrics suspect of acute appendicitis in Imam Hossein hospital. Patients and Methods: This was a retrospective study conducted at Imam Hossein hospital from 2015-2017. The study population was all children with suspected appendicitis who refer to Imam Hossein medical center in Isfahan. The sample size was 423 people. The collected data were imported into SPSS software version 22 and analyzed with appropriate statistical tests. The significance level in the present study was less than 0.05. Results: The average age of participants was 7.2 ± 3.8 years. In both study groups, it was observed that the mean NLR in the normal and reactive follicular groups was significantly lower than the appendicitis and complication groups (P<0.05). The results of the present study showed that NLR diagnostic test can be a good predictor for the evaluation of appendicitis in both groups under 4 years and over 4 years. For more than 4 years’ group; AUC=0.74, P<0.001 and for less than 4 years’ group; AUC=0.69, P<0.001. For less than 4 years’ group, the cut-off score for appendicitis diagnosis was 2.3. In this cut-off, the sensitivity and specificity were equal to 0.65% and 0.72%. Additionally, for more than 4 years’ group, the cut-off for the diagnosis of appendix was 3.5. In this cut-off, the sensitivity and specificity were equal to 0.73% and 67%. Conclusion: This analysis demonstrates that NLR, in the context of appropriate clinical assessment of patients with a high a priori probability of appendicitis, has a greater diagnostic accuracy in supporting the diagnosis of appendicitis.

Diagnostic Performance and Reliability of the Standardized Computed Tomography Reporting System for Acute Appendicitis: Experience in a Tertiary Care Academic Center

2021 ◽  
Vol 104 (7) ◽  
pp. 1102-1108
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Interobserver Agreement ◽  
Reporting System ◽  
Lower Quadrant ◽  
Suspected Appendicitis ◽  
Diagnostic Certainty

Background: Computed tomography (CT) is generally accepted as a modality of choice for imaging workup in patients with suspected appendicitis. A standardized CT reporting system, CT certainty score, has been proposed to improve diagnostic accuracy and to reduce ambiguous CT reports. Objective: To assess the diagnostic performance and the reliability of the standardized CT reporting system for acute appendicitis in Thai adults. Materials and Methods: The present study was a retrospective data review of 421 adult patients who had CT scans of the appendix between January 2016 and December 2017. The clinical and imaging data were extracted and analyzed. The pathological result was used as a standard of reference. The diagnostic performance and interobserver agreement of the standardized CT reporting system were estimated. Results: One hundred sixty-three patients, with a mean age of 41.7 years, had clinical diagnoses of acute appendicitis. Using standardized CT report, radiologists were highly accurate at diagnosing appendicitis [area under curve (AUC) 0.988 (95% CI 0.98 to 1.00); p<0.001]. The estimated sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 95.1% (95% CI 90.6 to 97.9), 95.7% (95% CI 92.5 to 97.9), 93.4% (95% CI 88.7 to 96.2), 96.9% (95% CI 93.0 to 97.2), 95.5% (95% CI 93.0 to 97.3), respectively. The interobserver agreement was greater than 80% for all binary objective findings and more than 90% agreement on the presence or absence of greater-than-3-mm wall thickness, appendicolith, periappendiceal air, and right lower quadrant fluid collection. The use of CT certainty score had interobserver agreement of 78% (κ=0.69; 95% CI 0.62 to 0.77). Conclusion: Using a standardized CT reporting system yielded a high diagnostic accuracy and high reproducibility of supportive CT findings for appendicitis in at-risk patients. The standardized CT reporting system can improve diagnostic certainty, accuracy, and guide patient management. Keywords: Appendicitis; Certainty score; Computed tomography; Standardized reporting system

sTREM-1 assessment as a diagnostic biomarker for suspected acute appendicitis in children

2019 ◽  
Author(s):  
Tal Taraboulos Klein ◽  
Elkana Kohn ◽  
Baruch Klin ◽  
Tomer Ziv-Baran ◽  
Eran Kozer ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Complete Blood Count ◽  
Surrogate Marker ◽  
Serum Levels ◽  
Alvarado Score ◽  
Suspected Appendicitis ◽  
Reactive Protein ◽  
Significant Difference ◽  
History Of ◽  
Suspected Acute Appendicitis

Abstract Background The typical history of acute appendicitis is observed in less than 60% of cases. Therefore, searching for a surrogate marker is mandatory. Our goal was to determine whether the soluble triggering receptor expressed on myeloid cells (sTREM-1) is an efficient biomarker for acute appendicitis. Methods sTREM-1 serum levels were measured in addition to carrying out routine diagnostic tests (urine dipstick, complete blood count and C- reactive protein) in children admitted to the Emergency Department with suspected appendicitis. Statistical analysis was performed in order to examine whether sTREM-1 was a significant predictor of appendicitis. Results Fifty three of 134 children enrolled in the study were diagnosed with appendicitis. There was no significant difference in serum sTREM-1 levels (p=0.111) between children with or without appendicitis. Leukocytes, neutrophils and CRP were significantly elevated in the appendicitis group (p<0.001). The appendix diameter was significantly larger and the Alvarado score significantly higher in the appendicitis group (p<0.001). Conclusion serum sTREM-1 is not a good marker for acute appendicitis. Customary tests in addition to a proper patient history and physical examination are still the most effective methods to diagnose acute appendicitis.

scholarly journals Outcome of diagnosed cases of appendicitis and diagnostic accuracy of ultrasound of the appendix

2020 ◽  
Vol 13 (1) ◽  
pp. 56-59
Author(s):  
Bhoj Raj Sharma ◽  
Nawaraj Paudel ◽  
Santwana Parajuli ◽  
Sushma Singh ◽  
Madhu Maya Timilsina
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Surgical Outcome ◽  
Perforated Appendicitis ◽  
College Teaching ◽  
Free Fluid ◽  
Pelvic Cavity ◽  
Negative Appendectomy ◽  
Ultrasound Scan ◽  
Suspected Appendicitis

Background: Acute appendicitis is the most common condition requiring an emergency ultrasound scan as well as surgery. Several scoring systems for acute appendicitis has been suggested to improve diagnostic accuracy and decrease the negative appendectomy rate. In this study, we have evaluated the diagnostic performance of ultrasound on the diagnosis of acute appendicitis, other appendicular pathology, and correlate with surgical outcome. Material and methods: This retrospective study included 776 cases of ultrasound scan reports in which the appendix was visualized and not visualized or equivocal. Data were collected from October 2014 to April 2019 from different department and wards of Gandaki Medical College Teaching Hospital and Research Center (GMCTHRC). All the cases with diagnosed acute appendicitis, appendicular lump, and appendicular abscess were included and were followed for its surgical outcome. The surgical note or post-operative findings served as the reference standard for determining whether perforation was present or not. Result: There were 776 ultrasound scans for suspected appendicitis out of which 423 (54.5%) were diagnosed as appendicular pathology. Out of 423 diagnosed cases, 192 (45.4%) were males and 231 (54.6%) were females, with age ranging from 24 months to 87 years. Sonographic findings, in these positive subjects, suggested acute appendicitis, appendicular lump, abscess, and amount of free fluid in right iliac fossa (RIF) and pelvic cavity. Frank acute appendicitis was present in 378 (89.3%) cases, eight (1.9%) cases had an appendicular abscess, 23 (5.4%) had an appendicular lump and 14 (3.3%) had perforated appendicitis. Conclusion: We conclude that ultrasound is a good modality for visualization of appendicitis with other appendicular pathology. We could follow a structured report and identify pathology more specifically. Ultrasound is an easy and non-invasive test to investigate.  

Can Computed Tomography Scan be Performed Effectively in the Diagnosis of Acute Appendicitis without the Added Morbidity of Rectal Contrast?

2008 ◽  
Vol 74 (10) ◽  
pp. 917-920 ◽  
Author(s):  
Daniel D. Dearing ◽  
Jamesa Recabaren ◽  
Magdi Alexander
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
Ct Scanning ◽  
Ct Scans ◽  
Negative Appendectomy ◽  
Suspected Appendicitis ◽  
Ct Examination ◽  
Preoperative Ct ◽  
Negative Appendectomy Rate ◽  
Pathology Reports

The highest degrees of accuracy have been demonstrated for CT scans using rectal contrast in diagnosing appendicitis. However, the administration of rectal contrast is associated with patient discomfort and rarely, rectosigmoid perforation (0.04%). Additionally, the commonly accepted negative appendectomy rate is around 16 per cent. We performed a retrospective review of radiology, operative, and pathology reports of consecutive patients undergoing appendectomy or CT examination for appendicitis during 2006. CT scans were performed without rectal contrast. The accuracy of each type of inpatient CT examination and negative appendectomy rates were determined. Two hundred and thirty-eight patients underwent appendectomy. One hundred and thirty-four appendectomy patients (56%) received a preoperative CT scan. The negative appendectomy rates were 6.3 per cent overall, 8.7 per cent without CT examination and 4.5 per cent with CT (P = 0.3). Two hundred and forty-five inpatient CT scans were performed for suspected appendicitis with a sensitivity of 90 per cent, specificity of 98 per cent, accuracy of 94 per cent, positive predictive value of 98 per cent, and negative predictive value of 91 per cent. CT scanning without rectal contrast is effective for the diagnosis of acute appendicitis making rectal contrast, with its attendant morbidity, unnecessary. The previously acceptable published negative appendectomy rate is higher than that found in current surgical practice likely due to preoperative CT scanning.

scholarly journals Should the laparoscopic approach be the norm for appendicectomy in the third trimester of pregnancy?

2019 ◽  
Vol 12 (4) ◽  
pp. e228192
Author(s):  
Hashviniya Sekar ◽  
Nisha Rajesh Thamaran ◽  
David Stoker ◽  
Sayantana Das ◽  
Wai Yoong
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Approach ◽  
Postoperative Recovery ◽  
Laparoscopic Appendicectomy ◽  
Third Trimester ◽  
Invasive Approach ◽  
Suspected Appendicitis ◽  
The Third ◽  
Trocar Placement ◽  
Theoretical Risk

Our case describes a pregnant woman with acute appendicitis who presented in the third trimester and underwent a laparoscopic appendicectomy. She made a rapid postoperative recovery and the pregnancy was otherwise uncomplicated, ending with a spontaneous vaginal birth at 41 weeks. The diagnosis of acute appendicitis can be unclear in pregnancy. Difficulty in establishing diagnosis due to atypical presentation often leads to delay in surgery, resulting in significant maternal and fetal morbidity and mortality. Surgical intervention should be prompt in cases of suspected appendicitis and the laparoscopic approach is advocated in the first two trimesters. In the third trimester (after 28 weeks), laparotomy is often performed due to the size of the uterus and the theoretical risk of inadvertent perforation with trocar placement. More recently, several authors have described successful outcomes following laparoscopic appendicectomy after 28 weeks and with increasing reassuring data, we suggest that this minimally invasive approach should be considered in managing appendicitis in the third trimester.

Diagnostic score in acute appendicitis. Validation of a diagnostic score (Lintula score) for adults with suspected appendicitis

2010 ◽  
Vol 395 (5) ◽  
pp. 495-500 ◽  
Author(s):  
Hannu Lintula ◽  
Hannu Kokki ◽  
Jukka Pulkkinen ◽  
Riikka Kettunen ◽  
Oskari Gröhn ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Score ◽  
Suspected Appendicitis
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