scholarly journals Acute appendicitis: not just a therapeutic puzzle to solve

2017 ◽  
Author(s):  
Emanuele Rausa ◽  
Michele Pisano ◽  
Federico Coccolini ◽  
Marco Ceresoli ◽  
Niccolo Allevi ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Gold Standard ◽  
Blind Spot ◽  
Scientific Attention ◽  
Remarkable Advantage

Over the last 5 years, acute appendicitis (AA) is definitely drawing the scientific attention. As the timing in efficiently and promptly treating patients with AA is essential, any potential blind spot in understanding the disease should be clarified. Consequently, physicians will be able to address the patient towards the more appropriate therapeutic pathway (antibiotic or surgery) and avoid any harmful delay. Currently, neither surgery nor antibiotic seem offer a remarkable advantage to the patients therefore surgery remains the gold-standard in treating AA in accordance to the historical dogma.

scholarly journals Evaluation of Ultrasonography in the Diagnosis of Acute Appendicitis with Histopathology as Gold Standard

2019 ◽  
Vol 14 (2) ◽  
pp. 13-16
Author(s):  
Ahmed N. Manea ◽  
Tawfeeq J. Mohammad ◽  
Sarmad J. Shehatha
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
Gold Standard ◽  
Life Time ◽  
Categorical Variables ◽  
Histopathological Study ◽  
P Value ◽  
Compression Technique ◽  
Cross Sectional ◽  
Suspected Appendicitis

Background: Acute appendicitis is the most common surgical abdominal emergency with a life time prevalence of 1 to 7 individuals. Because the clinical diagnosis of acute appendicitis remains a challenge to surgeons, so different aids were introduced like different scoring systems, computer aided programs, ultrasonography, computerized tomography, Magnetic resonance imaging, Gastrointestinal tract contrast studies and laparoscopy to improve the diagnostic accuracy. Objective: To evaluate ultrasound in the diagnosis of acute appendicitis in those patients clinically diagnosed with histopathology as gold standard. Methods: A cross sectional study carried in Al-kindy Teaching Hospital through one year duration from 1st of may2015 to1st of May 2016. All included patients were subjected to ultrasonographic examination to assess the vermiform appendix with a graded compression technique. The Ultrasonography findings were recorded as positive and negative for acute appendicitis. All the appendices removed from the study patients were sent for histopathological study. Statistical analysis done using (SPSS) version 21, Chi-sequare test used for categorical variables and t-test was used to compare between two means. Level of significance (P value) set at ≤ 0.05. Results: A total of 215 patients with suspected appendicitis, males 112 (52.09%) and females 103(47.9%) were included in present study. The validity results of ultrasound in comparison with histopathology findings were as following; accuracy 86.5%, sensitivity 86.5%, specificity 86.6%, positive predictive value 99.8% and negative predictive value 32.5%. Conclusion: The ultrasonography has a good accuracy, sensitivity and specificity in diagnosing acute appendicitis.

A Comparison between the Diagnostic Accuracy of Alvarado and Tzanaki Scoring Systems in Acute Appendicitis

2021 ◽  
Vol 15 (12) ◽  
pp. 3175-3177
Author(s):  
Anum Iftikhar ◽  
Muhammad Arsalan ◽  
Sheeza Azaz ◽  
S H Waqar ◽  
Sajid Ali Shah ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Scoring Systems ◽  
Negative Appendectomy ◽  
Alvarado Score ◽  
Cross Sectional

Aim: To find out how accurate the Alvarado and Tzanaki scoring systems are in diagnosing acute appendicitis taking histopathology as gold standard. Methods: A cross-sectional prospective study was conducted from August 2019 to July 2020 at Department of General Surgery, Pakistan Institute of Medical Sciences Islamabad. Sixty patients were included, all of whom had appendectomies after a clinical diagnosis of acute appendicitis. Samples were submitted for histopathology, which was used as the gold standard for the definitive diagnosis of acute appendicitis. The specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy and negative appendectomy rate of Alvarado and Tzanaki scoring systems was calculated using SPSS version 23. Results: The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of Alvarado score at optimal cut-off threshold of ≥7.0, were calculated as 74%, 55%, 90%, 27% and 71.66% respectively. The cut-off threshold point of Tzanaki score was set at more than 8, which yielded a 94.11% sensitivity and an 88.88% specificity. The positive predictive value was 99.95% and the negative predictive value was 72.72%. The Alvarado and Tzanaki scoring systems had negative appendectomy rates of 9.5% and 2.04%, respectively. Conclusion: The Tzanaki scoring system has a better diagnostic accuracy for acute appendicitis as compared to the Alvarado score. Keywords: Acute appendicitis, Alvarado score, Tzanaki score

scholarly journals EP.FRI.477 Neutrophil-To-Lymphocyte Ratio (NLR) as a Predictor of Acute Appendicitis

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Sadia Tasleem ◽  
Nadia Gulnaz
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Complicated Appendicitis ◽  
Neutrophil To Lymphocyte Ratio ◽  
College Hospital ◽  
Duration Of Symptoms ◽  
Lymphocyte Ratio ◽  
Study Results ◽  
Sensitivity Specificity

Abstract The most common reason for an acute surgical assessment of the abdomen is acute appendicitis with a rate as high as 30 %There is a   lifetime risk of 8.6% and 6.7% in men and women respectively. The common age for presentation is between that of 5 and 4.4 while 28 is the median age. The objective of this study was to determine   the diagnostic accuracy   of (NLR) neutrophil-to-lymphocyte ratio to prognosticate severe/ complicated appendicitis by taking histopathology of the appendix as a gold standard. Methodology This cross-sectional validation study was conducted at the department of surgery and western vascular institute, University College Hospital Galway, Ireland retrospectively for a period of 6 months in 2016 And approximately 186 cases with appendicitis were enrolled in the study. Results The mean age of patients in this study was 29.15±9.54 years, the ratio of male to female was 1:1.7.   The sensitivity, Specificity was 97.1% and   25.2% respectively and the diagnostic accuracy of NLR was 38.7% taking histopathology as the gold standard. We observed that the sensitivity, specificity, and diagnostic accuracy of NLR   changes with the duration of symptoms in days, the sensitivity, specificity, and diagnostic accuracy of NLR was 100%, 17.0%, and 28.7%    respectively for <3days   and 92.3%, 93.75% and93.1% respectively for >3 days. Conclusion According to our study results the (NLR) neutrophil-to-lymphocyte ratio is a highly sensitive tool to predict severe/   complicated appendicitis by taking histopathology as the gold standard, but with the low value of diagnostic accuracy in terms of specificity.

scholarly journals EP.WE.613A multi-centre review of the management of acute appendicitis during the COVID-19 pandemic

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Jessica Ruth Lockhart ◽  
Scarlett O'Brien ◽  
Lara Armstrong ◽  
Aidan Armstrong ◽  
Damian McKay
Keyword(s):  
Acute Appendicitis ◽  
Conservative Management ◽  
Gold Standard ◽  
Standard Treatment ◽  
Ct Scans ◽  
Control Group ◽  
Diagnostic Uncertainty ◽  
Number Of Patients ◽  
The Difference ◽  
Definitive Management

Abstract Aim Acute appendicitis is a common surgical presentation and is historically a clinical diagnosis; gold-standard treatment is appendicectomy. Due to anticipated increased demand on in-patient beds during the COVID-19 pandemic there was increased emphasis on conservative management of acute appendicitis. Our aim is to review these changes and determine the representation rate following conservative management. Methods Patients with acute appendicitis were identified from daily referral lists across two trusts. Data was collected using electronic care records. A control group (106 patients) was identified from 3 months preceding the pandemic. Results In the pandemic group, 213 patients had acute appendicitis; 47% were managed conservatively, compared to 8% of the control group. Overall, during the pandemic 44% of patients had a CT-confirmed diagnosis (compared to 48% of control group); the two trusts’ results varied showing 75% and 30% (compared to 46% and 51% respectively in the control group). Of those treated conservatively only 3% represented to hospital and required admission. Conclusion Significantly more patients were treated conservatively during the COVID-19 pandemic. The larger number of patients managed as acute appendicitis in the pandemic group may represent over-diagnosis due to the decision to conservatively manage these patients and account for diagnostic uncertainty. Increased access to early diagnostic CT scans facilitated early decisions regarding definitive management. Variation in access to radiology both during and before the pandemic may account for the difference in use of CT scans. Low rates of readmission to hospital following conservative management of acute appendicitis have been observed to date.

Diagnostic Accuracy of Increased Mean Platelet Volume as Inflammatory Marker in Diagnosis of Acute Appendicitis Taking Histopathology as Gold Standard

2021 ◽  
Vol 15 (10) ◽  
pp. 2790-2792
Author(s):  
Hina Rehman Siddiqui ◽  
Tahira Tariq ◽  
Samar Babiker Awadallah Omer ◽  
Nadia Rizvi
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Mean Platelet Volume ◽  
Inflammatory Marker ◽  
Total Leukocyte Count ◽  
Platelet Volume ◽  
Duration Of Symptoms ◽  
Predictive Values ◽  
Sensitivity Specificity

Objective: To determine diagnostic accuracy of increased mean platelet volume as inflammatory marker in diagnosis of acute appendicitis taking histopathology as gold standard. Study Design: Cross Sectional Study. Setting: Department of Surgery, Abbasi Shaheed Hospital, Karachi. Duration: From 28th October 2016 To 27thApril 2017. Material and Methods: Total 229patients suffered from acute appendicitis were included. Venous blood (<20 ml) for complete blood count was sent to lab before surgery. MPV >11fl was taken as increased value. Post-appendicectomy appendix was sent for histopathology. Sensitivity, specificity, positive and negative predictive values were calculated. Stratification was done. Chi-square test was applied post stratification and p-value ≤0.05 was considered as significant. Results: There were 128 male and 101 female. Mean age was 34.09±6.63 years. Mean duration of symptoms was 28.97±11.89 hours. 107 patients were observed with total leukocyte count >10X103µL. Mean platelets volume was more than 11 fl in 47.2% patients. Sensitivity, Specificity, PPV, NPV and accuracy were 74.6%, 91.6%, 92.5%, 71.9%, and 81.6% respectively. Conclusion: In conclusion in patients with temporary diagnosis of acute appendicitis, high MPV “≥ 11fl” can assist in the identification of acute appendicitis hence negative rate of appendectomy can be decreased.. Keywords: Diagnostic Accuracy, Increased Mean Platelet Volume, Acute Appendicitis, Histopathology

Laparoscopic appendectomy - the 'gold standard' technique for all kinds of acute appendicitis

2018 ◽  
Vol 24 (2) ◽  
pp. 3 ◽  
Author(s):  
A. P. Ukhanov ◽  
D. V. Zakharov ◽  
S. V. Bolshakov ◽  
S. A. Zhilin ◽  
A. I. Leonov ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Gold Standard ◽  
Standard Technique ◽  
Gold Standard Technique

scholarly journals To determine validity of ultrasound in predicting acute appendicitis among children keeping histopathology as gold standard

2019 ◽  
Vol 38 ◽  
pp. 22-27 ◽  
Author(s):  
Ubaidullah khan ◽  
Murad Kitar ◽  
Imed Krichen ◽  
Kais Maazoun ◽  
Rasha Ali Althobaiti ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Gold Standard
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