Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children

Abstract Background Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months. Methods The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. The medical records including laboratory data, computed tomography scans, pathology reports and operative notes were reviewed. Results The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses, as well as postoperative complications were observed between the two groups. Conclusions The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.

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Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children

10.21203/rs.2.14801/v5 ◽

2019 ◽

Author(s):

Yao-Jen Hsu ◽

Yu-Wei Fu ◽

Taiwai Chin

Keyword(s):

Acute Appendicitis ◽

Medical Records ◽

Laboratory Data ◽

Lymphoid Hyperplasia ◽

Clinical Findings ◽

Number Of Patients ◽

Computed Tomography Scans ◽

Pathology Reports ◽

Operative Notes ◽

Surgical Condition

Abstract Background Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months. Methods The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. The medical records including laboratory data, computed tomography scans, pathology reports and operative notes were reviewed. Results The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses, as well as postoperative complications were observed between the two groups. Conclusions The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.

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Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children

10.21203/rs.2.14801/v3 ◽

2019 ◽

Author(s):

Yao-Jen Hsu ◽

Yu-Wei Fu ◽

Taiwai Chin

Keyword(s):

Acute Appendicitis ◽

Medical Records ◽

Laboratory Data ◽

Lymphoid Hyperplasia ◽

Clinical Findings ◽

Number Of Patients ◽

Computed Tomography Scans ◽

Pathology Reports ◽

Operative Notes ◽

Surgical Condition

Abstract Background Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months. Methods The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. The medical records including laboratory data, computed tomography scans, pathology reports and operative notes were reviewed. Results The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses, as well as postoperative complications were observed between the two groups. Conclusions The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.

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Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children

10.21203/rs.2.14801/v2 ◽

2019 ◽

Author(s):

Yao-Jen Hsu ◽

Yu-Wei Fu ◽

Taiwai Chin

Keyword(s):

Acute Appendicitis ◽

Laboratory Data ◽

Lymphoid Hyperplasia ◽

Clinical Findings ◽

Enterovirus Infection ◽

Number Of Patients ◽

Computed Tomography Scans ◽

Laboratory Results ◽

Pathology Reports ◽

Surgical Condition

Abstract Background Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months. Methods The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. Laboratory data, computed tomography scans, pathology reports and operative records were reviewed. Results The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses were observed between the two groups. Conclusions The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.

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Seasonal variation of acute appendicitis and fecaliths in children

10.21203/rs.2.14801/v1 ◽

2019 ◽

Author(s):

Yao-Jen Hsu ◽

Yu-Wei Fu ◽

Taiwai Chin

Keyword(s):

Acute Appendicitis ◽

Laboratory Data ◽

Lymphoid Hyperplasia ◽

Clinical Findings ◽

Ct Scans ◽

Lower Percentage ◽

Significant Difference ◽

Laboratory Results ◽

The Difference ◽

Appendiceal Perforation

Abstract Purpose A higher incidence of acute appendicitis (AA) in summer has been reported. The reason of this observation is uncertain. The purpose of this study is to analyze the difference of the clinical findings between summer and non-summer AA. Methods We reviewed the clinical data of 171 patients who had an appendectomy from 2013 to 2016. The patients were under 18 years of age by the time of surgery. Laboratory data, CT scans, pathologic reports and operative records were reviewed. Results More appendectomies were performed in summer than non-summer months (101 patients vs 70 patients). There is no significant difference of laboratory results between the summer and non-summer patients. The percentage of AA patients with a fecalith is significantly lower in the summer (33.6%) than non-summer months (55.7%). There was no significant difference in appendiceal perforation/abscess between summer and non-summer months. Conclusions We observed a lower percentage of AA with a fecalith in summer. To our knowledge, this observation has not been reported in literature. The increase of AA in summer may be a result of more lymphoid hyperplasia in summer. This may correlate with the yearly outbreak of enteroviral infections in this area.

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Can Clinical Findings Prevent Negative Laparotomy in Parasitosis Mimicking Acute Appendicitis?

Advances in Emergency Medicine ◽

10.1155/2016/8313604 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5

Author(s):

Musa Zorlu ◽

İbrahim Tayfun Şahiner ◽

Ahmet Çınar Yastı ◽

Ethem Zobacı ◽

Ramazan Kocabaş ◽

...

Keyword(s):

Acute Appendicitis ◽

Rural Areas ◽

Young Patients ◽

Diagnostic Value ◽

Lymphoid Hyperplasia ◽

Clinical Findings ◽

City Centre ◽

Negative Laparotomy ◽

Number Of Patients ◽

Significant Difference

Objectives. Rates of negative laparotomy (NL) for acute appendicitis have been reported as 15% and parasitosis contributed to 2%. This study was planned to reduce the rates of NL by preoperative determination of parasitosis. Methods. In retrospective examination of 2730 appendectomy specimens in Hitit University Department of General Surgery between 2008 and 2012, 55 patients were determined with parasitosis and compared with 102 age-matched randomly selected patients with lymphoid hyperplasia. Results. The parasite group comprised 63.6% females with a mean age of 15.1 years. The number of patients in the parasitosis group increased from city centre to rural areas of towns and villages (p<0.001). While a lower rate of sonographic findings was found in the parasitosis group, the findings of inflammation in the histopathological evaluation were significantly low (p=0.014, p=0.0011, resp.). A significant difference was determined between groups in respect of the eosinophil and haematocrit values. In the differentiation of patients with parasites, eosinophil of >2.2% was determined as a diagnostic value. Conclusion. It is important to determine parasitosis to prevent NL. When acute appendicitis is considered for young patients living in rural areas, the observation of high eosinophil together with negative sonographic findings should bring Enterobius vermicularis parasitosis to mind and thereby should prevent NL.

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A Retrieval System for a Library of Pathology Reports, Slides and Kodachromes

Methods of Information in Medicine ◽

10.1055/s-0038-1636075 ◽

1972 ◽

Vol 11 (03) ◽

pp. 152-162 ◽

Cited By ~ 6

Author(s):

P. GAYNON ◽

R. L. WONG

Keyword(s):

Medical Records ◽

Operative Procedure ◽

Clinical Findings ◽

Free Text ◽

X Ray ◽

Inverted File ◽

Natural Language Parsing ◽

On Line ◽

Pathology Reports ◽

Frequency Counts

With the objective of providing easier access to pathology specimens, slides and kodachromes with linkage to x-ray and the remainder of the patient’s medical records, an automated natural language parsing routine, based on dictionary look-up, was written for Surgical Pathology document-pairs, each consisting of a Request for Examination (authored by clinicians) and its corresponding report (authored by pathologists). These documents were input to the system in free-text English without manual editing or coding.Two types of indices were prepared. The first was an »inverted« file, available for on-line retrieval, for display of the content of the document-pairs, frequency counts of cases or listing of cases in table format. Retrievable items are patient’s and specimen’s identification data, date of operation, name of clinician and pathologist, etc. The English content of the operative procedure, clinical findings and pathologic diagnoses can be retrieved through logical combination of key words. The second type of index was a catalog. Three catalog files — »operation«, »clinical«, and »pathology« — were prepared by alphabetization of lines formed by the rotation of phrases, headed by keywords. These keywords were automatically selected and standardized by the parsing routine and the phrases were extracted from each sentence of each input document. Over 2,500 document-pairs have been entered and are currently being utilized for purpose of medical education.

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Evaluation of Children's Appendicitis Score Compared With Pediatric Appendicitis Score in Diagnosis of Pediatric Appendicitis

Journal of Shahid Sadoughi University of Medical Sciences ◽

10.18502/ssu.v28i10.4921 ◽

2020 ◽

Author(s):

Mohammad Khaasteh ◽

Fariba Heidari ◽

Akram Motamedi ◽

Kafieh Aslani ◽

Masoud Jamshidi ◽

...

Keyword(s):

Acute Appendicitis ◽

Clinical Findings ◽

Diagnostic Methods ◽

Diagnostic Tools ◽

Diagnostic Challenge ◽

Diagnostic Features ◽

Surgical Field ◽

Us Findings ◽

Pathology Reports ◽

Appendicitis Score

Introduction: Identification and promotion of diagnostic methods has been a continuous effort to reduce disease and its complications and reduce costs associated with treatment. Despite all these efforts and improving our knowledge of diseases and diagnostic tools, pediatric appendicitis remains part of the diagnostic challenge in the surgical field. The aim of this is to compare the two diagnostic criteria of appendicitis (Children's Appendicitis Score [PAS] Versus Pediatric Appendicitis Score [CAS]) and evaluation of the diagnostic features of them. Methods: A retrospective cohort study was conducted on all children admitted to the hospital's emergency center with a possible diagnosis of appendicitis (270 patients) during 2018 and 2019 at Tabriz Pediatric Hospital. Based on the clinical examinations and para-clinical findings some of the patients were underwent the surgical intervention (220 cases) and some discharged and followed up for a period of 2 and 4 weeks later (50 cases). The data were analyzed through SPSS ver. 16 software. Results: The results of the present study indicated that if CAS was associated with ultrasound, the specificity of these criteria would improve and could be more acceptable compared with the PAS. In addition, it was revealed that WBC≥11000, as well as PMN≥65% and guarding were very specific for diagnosis and complication of acute appendicitis. There was a significant relationship between US findings and pathology reports (P<0.05). Conclusion: In conclusion, the CAS criteria were more sensitive and the PAS was more specific in diagnosing pediatric acute appendicitis.

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The Accuracy of Point-of-Care Ultrasound in the Diagnosis of Acute Cholecystitis

The American Surgeon ◽

10.1177/0003134821989057 ◽

2021 ◽

pp. 000313482198905

Author(s):

Chase J. Wehrle ◽

Asif Talukder ◽

Lillie Tien ◽

Soham Parikh ◽

Aditya Devarakonda ◽

...

Keyword(s):

Acute Cholecystitis ◽

Point Of Care ◽

Tertiary Care ◽

Laboratory Data ◽

Final Diagnosis ◽

Gallbladder Wall ◽

Clinical Findings ◽

Point Of Care Ultrasound ◽

Tokyo Guidelines ◽

Pathology Reports

Purpose Acute cholecystitis (AC) affects 50-200 000 patients per year. Early surgery is the treatment of choice for AC. Therefore, timely diagnosis is important to begin proper management. Recently, emergency departments have adopted point-of-care ultrasound (POCUS) for the initial evaluation of AC. The accuracy of POCUS for AC has not been well studied. Methods Patients receiving POCUS for evaluation of AC in the emergency department at our tertiary care institution for 2 years were considered. Patients with previous biliary diagnoses were excluded. Patients were deemed to have AC from a recorded POCUS result or 2/3 of the following POCUS findings: pericholecystic fluid, gallbladder wall hyperemia, and sonographic Murphy’s sign. Formal ultrasound and final diagnosis from surgical and pathology reports were used as gold standards for comparison. Results In total, 147 patients met inclusion criteria. POCUS had a sensitivity and specificity of .4 (95% CI: .1216-.7376) and .99 (.9483-.9982), respectively, when compared to a final diagnosis and .33 (.0749-.7007) and .94 (.8134-.9932) when compared to formal US. The modified Tokyo guidelines for suspicion of AC had a sensitivity of .2 (.0252-.5561) and specificity of .88 (.8173-.931) compared to the final diagnosis. Conclusion Point-of-care ultrasound was not a better screening test than the modified Tokyo guidelines. We recommend a simplified screening approach for AC using clinical findings and laboratory data, followed by confirmatory formal imaging. This strategy could prevent unnecessary delays in surgical management and use of physician resources.

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Analysis of Deliberate Self-Wrist-Cutting Episodes Presenting to the Emergency Department

Crisis ◽

10.1027/0227-5910/a000361 ◽

2016 ◽

Vol 37 (2) ◽

pp. 155-160 ◽

Cited By ~ 2

Author(s):

Jin Kim ◽

Han Joon Kim ◽

Soo Hyun Kim ◽

Sang Hoon Oh ◽

Kyu Nam Park

Keyword(s):

Emergency Department ◽

Medical Records ◽

Attempted Suicide ◽

Suicide Attempts ◽

Psychiatric Interview ◽

Clinical Variables ◽

Completed Suicide ◽

Number Of Patients ◽

Group A ◽

Efficacy Of Treatment

Abstract. Background: Previous suicide attempts increase the risk of a completed suicide. However, a large proportion of patients with deliberate self-wrist cutting (DSWC) are often discharged without undergoing a psychiatric interview. Aims: The aims of this study were to investigate the differences in the characteristics and outcomes of patients with DSWC and those with deliberate self-poisoning (DSP) episodes. The results of this study may be used to improve the efficacy of treatment for DSWC patients. Method: We retrospectively reviewed the medical records of 598 patients with DSWC and DSP who were treated at the emergency department of Seoul Saint Mary's Hospital between 2008 and 2013. We assessed sociodemographic information, clinical variables, the reasons for the suicide attempts, and the severity of the suicide attempts. Results: A total of 141 (23.6%) patients were included in the DSWC group, and 457 (76.4%) were included in the DSP group. A significantly greater number of patients in the DSWC group had previously attempted suicide (p = .014). A total of 63 patients (44.7%) in the DSWC group and 409 patients (89.5%) in the DSP group underwent psychiatric interviews. Conclusion: More DSWC patients had previously attempted suicide, but fewer of them underwent psychiatric interviews compared with the DSP patients.

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