Kết quả điều trị phẫu thuật nội soi viêm ruột thừa ở phụ nữ mang thai tại Bệnh viện Đa khoa Tỉnh Thái Bình

TÓM TẮT Mục tiêu: Đánh giá kết quả điều trị phẫu thuật nội soi viêm ruột thừa ở phụ nữ mang thai tại bệnh viện Đa khoa tỉnh Thái Bình. Phương pháp nghiên cứu: Mô tả hồi cứu 35 trường hợp viêm ruột thừa ở phụ nữ mang thai được điều trị phẫu thuật nội soi. Kết quả: 100% bệnh nhân được mổ cắt ruột thừa nội soi. Thời gian phẫu thuật trung bình 50,7 ± 13,6 phút (30 - 70 phút). Thời gian phẫu thuật kéo dài hơn ở nhóm viêm phúc mạc ruột thừa (56,7 ± 8 (40 - 70) phút) so với viêm ruột thừa mà không có viêm phúc mạc (p < 0,05). Có 3 trường hợp phải chuyển viện do sốt, dọa sẩy thai, dọa đẻ non. Kết quả điều trị 91,4 % kết quả tốt; 8,6% kết quả trung bình, không có trường hợp nào thai phụ bị tử vong, không có thai nhi bị tử vong. Kết luận: Phẫu thuật nội soi ổ bụng có thể ứng dụng an toàn để điều trị viêm ruột thừa ở phụ nữ mang thai, với tỉ lệ tai biến và biến chứng thấp cho thai phụ và thai nhi. ABSTRACT THE RESULTS OF TREATING APPENDICITIS USING LAPAROSCOPIC SURGERY IN PREGNANT WOMEN IN THAI BINH PROVINCIAL GENERAL HOSPITAL Objective: To evaluate the results of appendicitis endoscopic surgical treatment in pregnant women at Thai Binh Provincial General Hospital. Method: Retrospective describe of 35 pregnant women diagnosed with appendicitis treated using laparoscopic surgery. Results: 100% of patients underwent laparoscopic appendectomy. Average surgery time 50,7 ± 13,6 minutes (30 - 70 minutes). Surgery time was longer in the group of appendicitis (56,7 ± 8 (40 - 70) minutes) compared with appendicitis without peritonitis (p < 0,05). There were 3 cases of hospital transfer due to fever, threat of miscarriage, threat of preterm birth. Results of treatment 91,4% of the results were good; 8,6% of the average results, no case of death of the pregnant woman, no death of the fetus. Conclusion: Abdomen endoscopic surgical treatment can be used to treat appendicitis in pregnant women with low rate of complications for both the women and fetus. Key words: Acute appendicitis, appendicitis in pregnant women

Routine Histopathological Examination of Appendix. The Practice That Cannot Be Ignored.

Background: Acute appendicitis is a global disease that is usually caused by luminal obstruction with fecoliths. Aim: The aim of this study is to estimate the incidence of unusual findings in appendectomy specimens that can affect patient’s morbidity and mortality. Methods and Material: This is a retrospective study of 340 appendectomies that were preformed from January 2018 to December 2019 at King Hamad University Hospital (KHUH). Histopathological reports were reviewed and final diagnosis, age and gender were recorded. Results: Of the 340 appendectomy specimens, acute appendicitis was the most prevalent finding 62.64% (and showed significant correlation with both genders P value <0.001). Unusual findings were seen in (8.49%) cases and the commonest unexpected finding was fibrous obliteration (4.11%) followed by carcinoid (1.76%). Conclusions: this study revealed that although majority of appendicectomy cases fall in the spectrum of inflammatory cases with low incidence of unusual findings, it is atmost importance to perform the histopathological examination as it still change the course of treatment and affect the overall prognosis of the patients. Key words: Acute appendicitis, Acute abdomen, Appendix, Histopathology, Unusual findings.

Diagnosing Acute Appendicitis in Children Using Alvarado Score

Diagnosis of acute appendicitis in children with equivocal signs is often difficult requiring admission for observation, many of whom are finally discharged because they do not have appendicitis. This study was designed to see whether Alvarado score can aid in diagnosis of acute appendicitis. 71 children with age in between 5-15 were scored. The decision of surgery was made independent of the score. Appendicitis was confirmed in operated cases on operative and on histopathological findings. It was found that patients with low score have little chance to suffer from acute appendicitis. Therefore Alvarado scoring system can be used in taking decision in the diagnosis of acute appendicitis in children. Key Words: Acute Appendicitis; Alvarado Score DOI: http://dx.doi.org/10.3329/akmmcj.v2i2.8165 AKMMC J 2011; 2(2): 11-13

Acute appendicitis: Analysis of 518 histopathologically diagnosed cases at the Kathmandu University Hospital, Nepal

Background: Appendicitis is important as it is a common surgical emergency. There is no medical treatment for it, timely surgery is mandatory to prevent morbidity and mortality. Objectives: The objective of this study was to analyse the pathologic findings, the demographics, and, look for the existence of the so called aetiopathogenetic factors in the context of current prevailing beliefs regarding acute appendicitis, the most common current reason for emergency abdominal surgery. Materials and methods: This was a retrospective study. It was carried out at the Kathmandu University Hospital, Dhulikhel, Kavre, Nepal. All histopathologically diagnosed cases of acute appendicitis during the period January 1, 2004 to April 30, 2010 were included. Their macrospcopic and light microscopic examination findings were analyzed. Results: A total of 518 histopathologically diagnosed cases of acute appendicitis were found. Age distribution of these cases was between 6 to 84 years. Mean age was 30. 94 ± 15.75 years. Sex distribution consisted of 313 (60.42%) cases in males and 205 (39.58%) cases in females. Fecalith in the appendiceal lumen was seen only in 8 (1.54%) of cases. Granuloma and carcinoid was seen in 3 (0.58%) and 1 (0.19%) cases respectively. Perforation was seen in 11 (2.12%) cases. Foreign bodies, gallstones, strictures, helminthic infection, carcinoma or any other obvious/apparent aetiologic/ pathogenetic lesions/findings were not seen in any of the cases. Histopathologically staged distribution revealed that 180 (34.75%) cases were of early acute appendicitis, 250 (48.26%) cases were of acute suppurative appendicitis, and 88 (16.99%) cases were of acute gangrenous appendicitis. Conclusion: This study did not confirm the existing popular notion that luminal obstruction is the pathogenetic hallmark for acute appendicitis. Therefore, further research on this common surgical emergency is surely warranted. Key words: Acute appendicitis; fecalith; gangrenous DOI: 10.3126/kumj.v8i2.3564 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 227-230