Journal articles: 'Appendicite acuta'

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Chesca, Antonella, Tim Sandle, Galiya Abdulina, and P. Anamaria. "Acute phlegmonous appendicitis." Bulletin of the Karaganda University. “Biology, medicine, geography Series” 105, no. 1 (March 30, 2022): 136–42. http://dx.doi.org/10.31489/2022bmg1/136-142.

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Acute phlegmonous appendicitis is an outstanding topic in medicine. The issue can be approached in terms of diagnosis and the importance of practical surgery. The clinical diagnosis can be supported by macroscopic and microscopic anatomo-pathological diagnoses. The microscopic diagnosis can be established after studying morphological characteristics observed by analogy with microscopic preparations stained by traditional and special methods. Pathological microscopic preparations can be analyzed and compared with histological preparations that display normal appendix. This paper presents some best practice examples. To provide a precise explanation to medical staff, a series of images of microscopic slides were taken from patients for microscopic analysis. The creation of permanent microscopic slides was based on knowledge of the steps required for classical histological methods using standard H&E staining techniques. Samples were taken from patients of both sexes, children under 16 years old, from urban and rural areas. It is important to clarify misunderstood epidemiological features of appendicitis. Perforating and non-perforating appendicitis, apparently, are separate in nature, and since the need for spontaneous resolution of appendicitis is essential. It is important to have better quality reference materials to enable the medical staff to make the correct decision; this paper seeks to add to this area of knowledge. Ensuring that the diagnosis is correct can have important implications for the management of appendicitis suspicion. This must be supplemented with histological assessments together with important personal, heredocolateral antecedents in the patient’s pathological history. For example, determinations of the lymphocytopenia and neutrophil-lymphocyte ratio can predict bacteremia better than conventional infection markers in the emergency department. Histopathological analysis remains important for such determinations.

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Upadhyaya, P., AK Sinha, M. Agarwal, P. Paudyal, and A. Shrestha. "Incidental Enterobius Vermicularis infestation in surgically removed appendices with a clinical diagnosis of acute appendicitis: A retrospective analysis." Journal of Pathology of Nepal 5, no. 9 (March 27, 2015): 720–22. http://dx.doi.org/10.3126/jpn.v5i9.13778.

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Background: Appendiceal parasites can cause symptoms of appendicitis. Although the symptomatology imitates acute appendicitis clinically, the true nature of disease is diagnosed through histological examination. The aim of this study is to therefore determine the prevalence of E. Vermicularis in appendicectomy specimens to relate this to acute inflammation histologically.Materials & Methods: Histological data on all appendectomy specimens with a clinical diagnosis of acute appendicitis were retrieved from the archives of department of pathology, B.P.K.I.H.S, over the period of five years (January 2004- December 2008) and was analyzed retrospectively.Results: There were a total of 1528 patients. M:F ratio being 1.2:1.Inflamed appendix constituted for 94.24% of all cases. There were a total of six (0.39%) appendicectomy specimens which showed presence of oxyuriasis appendix. Though all patients with oxyuriasis presented with appendicial colic only one (1) out of the six cases of oxyuriasis showed histologic evidence of inflammation. Conclusion: We conclude that enterobius does not frequently cause inflammation of appendix though it may clinically mimic acute appendicitis. Since it represents a disease curable without necessitating surgery, symptomatology awareness is stressed upon.Journal of Pathology of Nepal (2015) Vol. 5, 720-722

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Vanhatalo, Sanja, Eveliina Munukka, Suvi Sippola, Sirpa Jalkanen, Juha Grönroos, Harri Marttila, Erkki Eerola, Saija Hurme, Antti J. Hakanen, and Paulina Salminen. "Prospective multicentre cohort trial on acute appendicitis and microbiota, aetiology and effects of antimicrobial treatment: study protocol for the MAPPAC (Microbiology APPendicitis ACuta) trial." BMJ Open 9, no. 9 (September 2019): e031137. http://dx.doi.org/10.1136/bmjopen-2019-031137.

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IntroductionBased on the epidemiological and clinical data, acute appendicitis can present either as uncomplicated or complicated. The aetiology of these different appendicitis forms remains unknown. Antibiotic therapy has been shown to be safe, efficient and cost-effective for CT-confirmed uncomplicated acute appendicitis. Despite appendicitis being one of the most common surgical emergencies, there are very few reports on appendicitis aetiology and pathophysiology focusing on the differences between uncomplicated and complicated appendicitis. Microbiology APPendicitis ACuta (MAPPAC) trial aims to evaluate these microbiological and immunological aspects including immune response in the aetiology of these different forms also assessing both antibiotics non-responders and appendicitis recurrence. In addition, MAPPAC aims to determine antibiotic and placebo effects on gut microbiota composition and antimicrobial resistance.Methods and analysisMAPPAC is a prospective clinical trial with both single-centre and multicentre arm conducted in close synergy with concurrent trials APPendicitis ACuta II (APPAC II) (per oral (p.o.) vs intravenous+p.o. antibiotics,NCT03236961) and APPAC III (double-blind trial placebo vs antibiotics,NCT03234296) randomised clinical trials. Based on the enrolment for these trials, patients with CT-confirmed uncomplicated acute appendicitis are recruited also to the MAPPAC study. In addition to these conservatively treated randomised patients with uncomplicated acute appendicitis, MAPPAC will recruit patients with uncomplicated and complicated appendicitis undergoing appendectomy. Rectal and appendiceal swabs, appendicolith, faecal and serum samples, appendiceal biopsies and clinical data are collected during the hospital stay for microbiological and immunological analyses in both study arms with the longitudinal study arm collecting faecal samples also during follow-up up to 12 months after appendicitis treatment.Ethics and disseminationThis study has been approved by the Ethics Committee of the Hospital District of Southwest Finland (Turku University Hospital, approval number ATMK:142/1800/2016) and the Finnish Medicines Agency. Results of the trial will be published in peer-reviewed journals.Trial registration numberNCT03257423

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Onafowokan, Oluwatobi O., Aboubakr Khairat, and Hugo J. R. Bonatti. "Appendiceal Diverticulitis in a Young Female Diagnosed on Pathology after Laparoscopic Appendectomy for Acute Appendicitis." Case Reports in Medicine 2021 (March 8, 2021): 1–3. http://dx.doi.org/10.1155/2021/2508956.

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Background. Appendiceal diverticulitis is a rare cause of inflammation of the appendix, which may mimic acute appendicitis. Its diagnosis is often delayed, and its occurrence carries an increased risk of significant complications, such as perforation. Case Presentation. A 23-year-old woman presented with sudden onset, severe, right lower quadrant abdominal pain and nausea. Her WBC was elevated, and abdominal CT showed findings indicative of acute appendicitis with a 13 mm fluid-filled appendix and local stranding. During laparoscopic appendectomy, significant inflammation was found around the appendix with some mucous material around the tip. The appendix base was not involved, and an endoloop was used to secure the stump. No other intra-abdominal abnormalities were observed. The patient recovered uneventfully. Pathology showed no classic appendicitis but appendiceal diverticulitis with signs of perforation. Discussion. Appendiceal diverticulitis is a rare condition which cannot be distinguished from acute appendicits clinically and on imaging. Diagnosis may be established based on pathology such as in our case. Appendectomy is indicated in appendiceal diverticulitis, and an appendix diverticulum is incidentally found during surgery or other investigations. This is due to the increased risk of perforation and the reported development of malignant tumors, including the appendix carcinoid.

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Mendoza-Rojas, Hubert James, and José Julio Valle Bayona. "Variación estacional de la apendicitis aguda." Horizonte Médico (Lima) 16, no. 2 (March 31, 2016): 19–26. http://dx.doi.org/10.24265/horizmed.2016.v16n2.04.

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Kidwai, Roman, and Anup Sharma. "Acute Perforated Appendicitis: Clinical Profile and Analysis of Risk Factors." Journal of Nepalgunj Medical College 16, no. 2 (December 31, 2018): 13–15. http://dx.doi.org/10.3126/jngmc.v16i2.24865.

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Introduction: The incidence of complicated acute appendicitis, including perforated or gangrenous appendicitis, remains considerably high (28-29%) despite the availability of modern imaging. Acute perforated appendicitis is associated with increased postoperative morbidity and mortality. The aim of the study was to analyze the clinico-pathological profile and outcomes for suspected perforated acute appendicitis and to determine the factors influencing the risk of perforated appendicitis. Materials and Methods: This was a prospective observational study conducted at Nepalgunj Medical College and Teaching Hospital from November 2016 to August 2018. Patients with suspected appendicle perforation were included. The diagnosis was confirmed atlaparotomy. History, physical findings, biochemical and radiological findings were noted. Results: There were 74 patients. The maximum number of patients were in the age group of 0-20 and 21-40 years with a male dominance (M:F 1.9:1). The common presenting features were pain starting in right iliac fossa and becoming generalized with features of peritonitis. Majority presented late to the hospital with the mean duration of 6.35±2.46 days. 17 (22.97%) patients had deranged renal function test at presentation. All patients underwent laparotomy and appendicectomy. The commonest site of perforation was the tip of appendix (58.08%). 27(52.94%) had generalized purulent peritonitis. All had features of acute appendicitis on histological examination. Of the 75 patients only 17 (22.97%) patients had fecolith. 21 (28.37%) had postoperative complications, commonest being surgical site infection (25.67%). Five (6.67%) patients died after surgery. The common cause of death was septic shock with multiorgan failure. Only one patient died due to myocardial infarction. The complications and mortality were common in those patients whose presentation was late i. e after 72 hours from the onset of symptoms, whose renal function was deranged, age > 60, and who had pyoperitoneum. CONCLUSION: Acute perforated appendix is not uncommon. Males are more common with younger people commonly getting affected. Delayed presentation, pyoperitoneum, age >60 are the common risk factors associated with morbidity and mortality.

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Sippola, Suvi, Juha Grönroos, Ville Sallinen, Tero Rautio, Pia Nordström, Tuomo Rantanen, Saija Hurme, et al. "A randomised placebo-controlled double-blind multicentre trial comparing antibiotic therapy with placebo in the treatment of uncomplicated acute appendicitis: APPAC III trial study protocol." BMJ Open 8, no. 11 (November 2018): e023623. http://dx.doi.org/10.1136/bmjopen-2018-023623.

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IntroductionRecent studies show that antibiotic therapy is safe and feasible for CT-confirmed uncomplicated acute appendicitis. Spontaneous resolution of acute appendicitis has already been observed over a hundred years ago. In CT-confirmed uncomplicated acute diverticulitis (left-sided appendicitis), studies have shown no benefit from antibiotics compared with symptomatic treatment, but this shift from antibiotics to symptomatic treatment has not yet been widely implemented in clinical practice. Recently, symptomatic treatment of uncomplicated acute appendicitis has been demonstrated in a Korean open-label study. However, a double-blinded placebo-controlled study to illustrate the role of antibiotics and spontaneous resolution of uncomplicated acute appendicitis is still lacking.Methods and analysisThe APPAC III (APPendicitis ACuta III) trial is a multicentre, double-blind, placebo-controlled, superiority randomised study comparing antibiotic therapy with placebo in the treatment CT scan-confirmed uncomplicated acute appendicitis aiming to evaluate the role of antibiotics in the resolution of uncomplicated acute appendicitis. Adult patients (18–60 years) with CT scan-confirmed uncomplicated acute appendicitis (the absence of appendicolith, abscess, perforation and tumour) will be enrolled in five Finnish university hospitals.Primary endpoint is success of the randomised treatment, defined as resolution of acute appendicitis resulting in discharge from the hospital without surgical intervention within 10 days after initiating randomised treatment (treatment efficacy). Secondary endpoints include postintervention complications, recurrent symptoms after treatment up to 1 year, late recurrence of acute appendicitis after 1 year, duration of hospital stay, sick leave, treatment costs and quality of life. A decrease of 15 percentage points in success rate is considered clinically important difference. The superiority of antibiotic treatment compared with placebo will be analysed using Fisher’s one-sided test and CI will be calculated for proportion difference.Ethics and disseminationThis protocol has been approved by the Ethics Committee of Turku University Hospital and the Finnish Medicines Agency (FIMEA). The findings will be disseminated in peer-reviewed academic journals.Trial registration numberNCT03234296; Pre-results.

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Ulukent, Suat Can, Nuri Alper Şahbaz, Eser Şefik Özyürek, İnanç Şamil Sarıcı, Özlem Akça, Mehmet Yiğit Özgün, Özgür Akbayır, and Mustafa Uygar Kalaycı. "Evaluation of laboratory parameters in the diagnosis of acute appendicitis." Turkish Journal of Biochemistry 43, no. 1 (December 15, 2016): 64–70. http://dx.doi.org/10.1515/tjb-2016-0224.

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AbstractIntroduction:The aim of this prospective study was to investigate the diagnostic value of the fibrinogen level, platelet (PLT) count, mean platelet volume (MPV), lymphocyte count, neutrophil/lymphocyte ratio (NLR) and C-reactive protein (CRP) level with white blood cell (WBC) and neutrophil count in acute appendicitis (AA).Methods:One hundred and ninety-seven patients who were admitted with the findings of acute abdomen and operated on with a preoperative diagnosis of AA were included in this prospective observational study. After surgery, according to the histopathological results of the appendix, patients were classified as Group 1; with normal histology of appendix vermicularis, Group 2; patients with positive histology for appendicitis with or without perforation, periappendiceal abscess, suppurative, gangrenous or ulcerophlegmonous appendicitis.Results:In the comparison of the two groups, the difference between CRP and MPV were insignificant (p=0.12 and p=0.09, respectively). WBC, neutrophil count, NLR were significantly higher in Group 2 (p<0.001 for each), whereas fibrinogen levels, lymphocyte count and the PLT counts were significantly higher in Group 1 (p=0.03, 0.002 and 0.003, respectively).Discussion and conclusion:WBC, neutrophil and NLR are predictive for the diagnosis of AA, whereas elevated levels of fibrinogen, high lymphocyte and PLT count are predictive for non-appendicial pathology with low diagnostic accuracies.

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RAMAHI, DR HAIDER ALI MUSLIM AL, and MUHAMMAD A. ALBAHADILI. "New Sign for Diagnosis of Acute Appendicitis." Journal of Research on the Lepidoptera 50, no. 4 (November 29, 2019): 171–76. http://dx.doi.org/10.36872/lepi/v50i4/201080.

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Rodrigues, André Luiz Santos, Marcelino Ferreira Lobato, Augusto César Santana, Lucas Crociati Meguins, and Daniel Felgueiras Rolo. "Pneumoperitoneum due to perforated appendicitis: a rare anatomo-radiologic correlation." ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) 21, no. 3 (September 2008): 142–43. http://dx.doi.org/10.1590/s0102-67202008000300011.

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BACKGROUND: Pneumoperitoneum is usually associated with a perforated peptic ulcer. However, perforated appendicits may be evolved on it. In the medical literature, the anatomo-radiologic correlation between them is an uncommon event. CASE REPORT: Man with 56-year-old look for assistance with diffuse abdominal pain and distension associated with fever, vomit and absence of flatus and evacuation for about 14 days. The chest radiography revealed a pneumoperitoneum. Diffuse peritonitis was found during the exploratory laparotomy. Appendectomy, peritoneal cavity cleaning and drainage with tubular drains were carried out. However, severe sepsis occurred and the patient died on the 16th post-operative day with multiple systemic organ failure. CONCLUSION: Although rare as pneumoperitoneum ethiology, acute appendicitis may be thought as it's cause.

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Hazarika, Abinash, and Chandana M.S. "Evaluation of Appendicitis Inflammatory Response Score in Diagnosis and Management of Acute Appendicitis." New Indian Journal of Surgery 9, no. 5 (2018): 554–59. http://dx.doi.org/10.21088/nijs.0976.4747.9518.2.

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Howie, John G. R. "Acute appendicitis: Acute appendicitis or acute appendicectomy?" BMJ 333, no. 7569 (September 21, 2006): 653.1. http://dx.doi.org/10.1136/bmj.333.7569.653.

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Nica, Adriana, Cristian Brănescu, Dragoş Şerban, Costel Şavlovschi, Ahed El Khatib, Corneliu Tudor, Geta Vancea, and Ana-Maria Dascălu. "Multidimensional preoperatory prediction of anatomo-pathologic result in acute appendicitis." Romanian Medical Journal 62, no. 4 (December 31, 2015): 412–19. http://dx.doi.org/10.37897/rmj.2015.4.17.

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The study aims that, starting from preoperative clinical and laboratory variables, to identify the most effective predictive multidimensional models for anatomopathological result in acute appendicitis. A prospective study was performed on 147 patients operated for acute appendicitis. The set of potential predictors considered for the selection is as follows: IL6, LBP, Alvarado score, total bilirubin, neutrophils count and WBC, all determined preoperatively. For data analysis we used a variant of a classic sequential analysis discrimination based on linear functions of Discrimination method of Fisher (SPSS). The most effective statistical models with an accuracy of classification of 100% were obtained from the variables: IL6 preop, LBP preop and WBC on admission Model 1) and IL6 preop, LBP preop and score Alvarado (Model 2). These observations lead us to believe that developing a procedure for preoperative diagnosis of appendicitis type is achievable. Defining, validating and assessing the reliability of such a procedure however require further research on a larger volume samples and are representative of both the pathology of appendicitis and population with acute appendicitis.

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Beniwal, Rajveer Singh, and Ragini Thapa. "Ultrasonography findings of appendicular wall thickness in acute appendicitis and recurrent appendicitis with pathological correlation." International Journal of Research in Medical Sciences 7, no. 11 (October 24, 2019): 4049. http://dx.doi.org/10.18203/2320-6012.ijrms20194620.

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Background: Appendicitis is among most common cause for acute abdominal pain requiring operative management. This study is to establish relationship between wall thickness of acute appendicitis and recurrent appendicitis with its pathological outcome.Methods: In this prospective study, 24 patients of acute appendicitis and 8 patients of recurrent appendicitis presenting as acute appendicitis were examined by High resolution Ultrasonography within 48 hrs of acute onset of symptoms following a detailed clinical examination. Alvarado scoring was done in all patients. Acute appendicitis and recurrent appendicitis were differentiated on the basis of clinical details and timeline of illness. Post operatively all specimens underwent gross and histopath examination and were divided into subgroups and tabulated as “early acute appendicitis”, “acute suppurative appendicitis” and “acute gangrenous Appendicitis”.Results: Wall thickness of acute appendicitis and recurrent appendicitis (presenting with acute onset of symptoms) were tabulated. Patients with wall thickness of <3mm had statistically significant higher prevalence of acute gangrenous appendicitis on pathological correlation. Patients with recurrent appendicitis had higher incidence of wall thickness <3mm, consequently increased incidence of acute gangrenous appendicitis. The value of z was 6.0715. The value of p is <0.00001. The result was significant at p <0.01 according to SPSS 16, which correlates well with findings.Conclusions: Wall thickness is an important indicator in the management of acute or recurrent appendicitis, wall thickness of <3mm or >3mm was decisive in patient management. Reduced wall thickness of appendix in patients with acute or recurrent appendicitis correlate with higher incidence of acute gangrenous appendicitis therefore are at higher risk of perforation and should be managed aggressively by surgical intervention to avoid complications.

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Rauenzahn, Sherri, Caroline Armstrong, Brendan Curley, Sarah Sofka, and Michael Craig. "Acute Myeloid Leukemia Presenting as Acute Appendicitis." Case Reports in Hematology 2013 (2013): 1–4. http://dx.doi.org/10.1155/2013/815365.

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Appendicitis in leukemic patients is uncommon but associated with increased mortality. Additionally, leukemic cell infiltration of the appendix is extremely rare. While appendectomy is the treatment of choice for these patients, diagnosis and management of leukemia have a greater impact on remission and survival. A 59-year-old Caucasian female was admitted to the surgical service with acute right lower quadrant pain, nausea, and anorexia. She was noted to have leukocytosis, anemia, and thrombocytopenia. Abdominal imaging demonstrated appendicitis with retroperitoneal and mesenteric lymphadenopathy for which she underwent laparoscopic appendectomy. Peripheral smear, bone marrow biopsy, and surgical pathology of the appendix demonstrated acute myeloid leukemia (AML) with nonsuppurative appendicitis. In the setting of AML, prior cases described the development of appendicitis with active chemotherapy. Of these cases, less than ten patients had leukemic infiltration of the appendix, leading to leukostasis and nonsuppurative appendicitis. Acute appendicitis with leukemic infiltration as the initial manifestation of AML has only been described in two other cases in the literature with an average associated morbidity of 32.6 days. The prompt management in this case of appendicitis and AML resulted in an overall survival of 185 days.

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Koimtzis, Georgios. "Appendiceal Endometriosis: A Rare Cause of Acute Appendicitis." Journal of Surgical Case Reports and Images 3, no. 5 (October 20, 2020): 01–03. http://dx.doi.org/10.31579/2690-1897/040.

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Background: Acute appendicitis is the most common cause of acute abdomen. The etiology has not been defined clearly but potential causes are fecoliths, lymphoid hyperplasia and malignancies. However, an extremely uncommon cause of acute appendicitis is endometriosis which leads to dilemmas in the diagnostic process. Case report: A 21-year-old Caucasian female patient presented in the Emergency department complaining of acute progressive abdominal pain in the right lower quadrant. The physical examination revealed signs consistent with acute appendicitis. The patient underwent diagnostic laparoscopy, which revealed early inflammation of the appendix and thus was subjected to appendicectomy. Histologic examination revealed endometriosis of the appendix. Conclusion: The presented case emphasizes on how endometriosis can affect only the appendix without any involvement of the reproductive organs. A high index of clinical suspicion is required especially in women of reproductive age who present with periodic chronic pain associated with their menstrual cycle. Nonetheless, this can only be confirmed through diagnostic laparoscopy and histologic examination, which also provides the definite cure of the disease.

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Joshi, Jignesh. "Application of Modified Alvarado Scores in Acute Appendicitis." New Indian Journal of Surgery 11, no. 2 (June 1, 2020): 155–57. http://dx.doi.org/10.21088/nijs.0976.4747.11220.12.

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Singh, Ravindra Nath, Jayanth D.H, Udaya Shankar, and Arjun C. "The Diagnostic Value of Bilirubin in Acute Appendicitis." New Indian Journal of Surgery 8, no. 3 (2017): 346–49. http://dx.doi.org/10.21088/nijs.0976.4747.8317.8.

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Ahmed, Hiwa O., Tahir Arif, and Alla Abdulkadir Shalli. "Role of Ultrasound in Diagnosis of Acute Appendicitis." Journal of Zankoy Sulaimani - Part A 9, no. 1 (September 23, 2005): 107–14. http://dx.doi.org/10.17656/jzs.10154.

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Lu, Yi-Ting, Po-Cheng Chen, Ying-Hsien Huang, and Fu-Chen Huang. "Making a Decision between Acute Appendicitis and Acute Gastroenteritis." Children 7, no. 10 (October 11, 2020): 176. http://dx.doi.org/10.3390/children7100176.

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Acute appendicitis is one of the most common pediatric abdominal emergencies. Early diagnosis is vital for a positive outcome. However, it may initially present with diarrhea and vomiting, mimicking acute gastroenteritis, thus delaying prompt surgery. Differentiating appendicitis from gastroenteritis in a timely manner poses a challenge. Therefore, we aim to investigate the predictors that help distinguish acute appendicitis from acute gastroenteritis. We conducted a retrospective case-control study, evaluating children admitted due to abdominal pain with diarrhea. Subjects were divided into two groups according to the final diagnoses: acute appendicitis and acute gastroenteritis. We adopted multiple logistic regression analysis and the area under the receiver operating characteristic curve to identify independent predictors of acute appendicitis and select the best model. A total of 32 patients diagnosed with appendicitis and 82 patients with gastroenteritis were enrolled. Five independent predictors of acute appendicitis included vomiting, right lower quadrant (RLQ) pain, stool occult blood (OB), white blood cell (WBC) count, and C-reactive protein (CRP). The revised combined model exhibited a higher degree of discrimination and outperformed the pediatric appendicitis score (PAS) model. In conclusion, our study was proved to be helpful for assessing cases with abdominal pain and diarrhea in order to more accurately distinguish appendicitis from gastroenteritis in children in a timely manner.

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Eddama, MMR, KC Fragkos, S. Renshaw, M. Aldridge, G. Bough, L. Bonthala, A. Wang, and R. Cohen. "Logistic regression model to predict acute uncomplicated and complicated appendicitis." Annals of The Royal College of Surgeons of England 101, no. 2 (February 2019): 107–18. http://dx.doi.org/10.1308/rcsann.2018.0152.

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Introduction While patients with acute uncomplicated appendicitis may be treated conservatively, those who suffer from complicated appendicitis require surgery. We describe a logistic regression equation to calculate the likelihood of acute uncomplicated appendicitis and complicated appendicitis in patients presenting to the emergency department with suspected acute appendicitis. Materials and methods A cohort of 895 patients who underwent appendicectomy were analysed retrospectively. Depending on the final histology, patients were divided into three groups; normal appendix, acute uncomplicated appendicitis and complicated appendicitis. Normal appendix was considered the reference category, while acute uncomplicated appendicitis and complicated appendicitis were the nominal categories. Multivariate and univariate regression models were undertaken to detect independent variables with significant odds ratio that can predict acute uncomplicated appendicitis and complicated appendicitis. Subsequently, a logistic regression equation was generated to produce the likelihood acute uncomplicated appendicitis and complicated appendicitis. Results Pathological diagnosis of normal appendix, acute uncomplicated appendicitis and complicated appendicitis was identified in 188 (21%), 525 (59%) and 182 patients (20%), respectively. The odds ratio from a univariate analysis to predict complicated appendicitis for age, female gender, log2 white cell count, log2 C-reactive protein and log2 bilirubin were 1.02 (95% confidence interval, CI, 1.01, 1.04), 2.37 (95% CI 1.51, 3.70), 9.74 (95% CI 5.41, 17.5), 1.57 (95% CI 1.40, 1.74), 2.08 (95% CI 1.56, 2.76), respectively. For the same variable, similar odds ratios were demonstrated in a multivariate analysis to predict complicated appendicitis and univariate and multivariate analysis to predict acute uncomplicated appendicitis. Conclusions The likelihood of acute uncomplicated appendicitis and complicated appendicitis can be calculated by using the reported predictive equations integrated into a web application at www.appendistat.com. This will enable clinicians to determine the probability of appendicitis and the need for urgent surgery in case of complicated appendicitis.

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Dragustinovis-Hinojosa, Gustavo, Jorge Aurelio Gutiérrez-González, and Dario Eduardo Medina-Muñoz. "Superior Mesenteric Vein Thrombosis as a Complication of Acute Appendicitis: A Rare Entity." International Journal of Medical and Surgical Sciences 09, no. 04 (December 13, 2022): 1–5. http://dx.doi.org/10.32457/ijmss.v9i4.1953.

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The complications of acute appendicitis have been widely described in the literature; Mesenteric venous thrombosis is a rare manifestation of this pathology corresponding to less than 1% frequency, this can confuse the general surgeon as it coexists with acute appendicitis. We present the case of a 58-year-old male patient, with abdominal pain of 5 days of evolution, with symptoms that are not very specific for the specific diagnosis of appendicitis. Computed tomography of the abdomen was performed with findings of acute appendicitis and mesenteric venous thrombosis with a clot of 11.5 cm. An open appendectomy was performed and anticoagulation was started on hospital discharge

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Ladyani, Festy, and Nur Fitria Dewi. "DIFFERENCES IN LEUKOCYTE RATE BETWEEN ACUTE NONPERFORATED AND PERFORATED APPENDICITIS IN HOSPITALISED PATIENTS BANDAR LAMPUNG-INDONESIA." Malahayati International Journal of Nursing and Health Science 2, no. 1 (April 11, 2019): 25–31. http://dx.doi.org/10.33024/minh.v2i1.1058.

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Background: Acute appendicitis is one of the most common acute abdominal pain. A late check up and diagnosis could bring harms which is turning into perforated appendicitis. Leukocyte count is a laboratory collation that is generous and quick to diagnose the acute apendicitis and perforated appendicitis, however there’s no certain limit of the leukocytes count to recognize whether it is acute apendicitis or perforated appendicitis.Purpose: This research was to find out the comparison of leucocyte count average between acute appendicitis and perforation appendicitis in Dr. H. Abdul Moeleok public hospital of Lampung province in 2014-2016.Methods: An analytic research with cross sectional approach. Population was 382 patients with appendicitis in Dr. Hi. Abdul Moeloek public hospital. Samples were taken using total sampling technique with 196 respondent samples for acute appendicitis and 196 respondent samples for perforation appendicitis. Data were analyzed by using univariate analysis with percentage and bivariate analysis with t-test.Results: the average of leucocyte count of acute appendicitis patients was 10,907 with minimum and maximum leucocyte count of 5,000 and 18,500 respectively. The average of leucocyte count of perforation appendicitis patients was 22,789 with minimum and maximum leucocyte count of 16,500 and 31,000 respectively. There were differences of leucocyte counts between acute appendicitis patients and perforation appendicitis patients with p-value < 0.05.Conclusion: there were significant differences of leucocyte count averages between acute appendicitis and perforation appendicitis.

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Mahmood, Arshad, Syed H. Raza, Elamin Elshaikh, Dushyant Mital, and Mohamed H. Ahmed. "Acute appendicitis in people living with HIV: What does the emergency surgeon needs to know?" SAGE Open Medicine 9 (January 2021): 205031212098246. http://dx.doi.org/10.1177/2050312120982461.

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Acute appendicitis is among the commonest surgical emergencies seen in an acute setting. Individuals living with the Human Immunodeficiency Virus (HIV) and/or the Acquired Immunodeficiency Syndrome (AIDS) have an increased risk of encountering complications with acute appendicitis. We conducted a literature search using the words appendicitis and HIV in google scholar, Medline, Scopus and PubMed. The search also extended to cover HIV presented with acute appendicitis, their outcome during and following the management of acute appendicitis. Several studies showed that HIV is associated with a higher rate of acute appendicitis than the general population. HIV can directly affect the appendix, through opportunistic infections, immune reconstitution inflammatory syndrome associated with start of antiretroviral medication. High index of suspicion is needed to exclude conditions that mimic acute appendicitis (abdominal tuberculosis, pyelonephritis, cytomegalovirus, cryptosporidium, pneumococcus, Amoebic appendicitis and pill impaction). The clinical presentation may not be typical of acute appendicitis and can be associated with low white cell count and variable fever. The Alvarado score for predicting acute appendicitis can be used and more research is needed to establish cut-off point value. Computed tomography scan and ultrasound are widely used in clinical diagnosis. Importantly, acute appendicitis with HIV/AIDS can be associated with high rate of post-surgical complications like infections, delay of healing, perforation, peritonitis, intra-abdominal abscess and longer hospital stay. HIV/AIDS with acute appendicitis is complex condition. Therefore, we conclude that patients with known HIV and acute appendicitis should also be managed in close liaison with HIV physicians during, before and after surgical treatment.

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Memon, Abdul Salam, Shahida Khatoon, Riaz Ahmed Memon, and Afzal Junejo. "ACUTE APPENDICITIS." Professional Medical Journal 22, no. 09 (September 10, 2015): 1212–16. http://dx.doi.org/10.29309/tpmj/2015.22.09.1140.

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Objectives: To study mean platelet volume (MPV) in acute appendicitis andits correlation with leukocyte count. Study Design: Case control study Place and Duration:Department of Surgery, Liaquat University of Medical and Health Sciences Jamshoro/Hyderabadfrom January 2013 to February 2014. Subjects and Methods: Subjects with clinical suspicionof acute appendicitis were selected according inclusion and exclusion criteria. A sample of 49acute appendicitis patients and 37 controls were studied. The Blood samples were collected insodium citrate vacutainers and processed on Sysmex KX 21 analyzers. The main analysis wasthe comparison of the difference of MPV between acute appendicitis and controls. Data wasanalyzed on SPSS version 21.0 by student’s t-test, Chi-square test and Pearson’s correlation (r)was used to evaluate association of MPV with platelet counts and leukocytes. A p-value of ≤0.05was taken significant. Results: The mean platelet volume and leukocytes were significantlyelevated in patients with acute appendicitis. MPV and leukocytosis in controls and cases werenoted as 7.93±2.1 vs. 9.10±2.9fl (p=0.0001) and 6980±120 vs. 13980±340 μL-1 respectively.MPV was positively correlated with leukocytosis (r=0.419) (p=0.0001), while Platelets showeda negative correlation. Conclusion: Elevated MPV and leukocytosis are observed in acuteappendicitis. MPV may be exploited for clinical diagnosis of acute appendicitis but in a properclinical context along with leukocytosis.

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Ambre, Sagar Ramesh, and Shahaji Chavan. "Hyperbilirubinemia as a diagnostic marker for acute appendicitis." International Surgery Journal 5, no. 6 (May 24, 2018): 2091. http://dx.doi.org/10.18203/2349-2902.isj20181977.

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Background: Appendicitis is one of the commonest cause of abdominal pain requiring emergency surgery. Different clinical signs and symptoms always mimic the diagnosis of acute appendicitis with number of causes leading to pain in right iliac fossa, especially in females. Accurate diagnosis can be aided by additional tests. A delay in diagnosis can lead to appendiceal perforation with increased morbidity, and an appendectomy as soon as the condition is suspected, may increase the number of unnecessary appendicectomies. Objective of present study was to evaluate the role of hyperbilirubinemia as a diagnostic marker for Acute Appendicitis.Methods: This is a prospective study of 100 patients carried out at Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune from May 2015 to September 2017. Patients presenting to surgical OPD with pain in Right iliac fossa will be evaluated. Those with a clinical diagnosis of acute appendicitis will be included in the study.Results: Acute appendicitis is one of the most common emergencies and appendicectomy is one of the most frequently done abdominal operations. Clinical diagnosis using time tested clinical signs is effective in diagnosing appendicitis. However, bilirubin supports diagnosis and hence avoids chances of error in diagnosis. The investigation Bilirubin alone is not sufficient to accurately diagnose acute appendicitis, however the clinical findings, ALVARADO SCORE when combined can predict appendicitis. There is significant difference in total bilirubin in acute and probable cases of appendicitis but it can be used to differentiate both of them. In present study Mean bilirubin for acute appendicitis was 1.23mg/dl and probable cases of appendicitis was 0.84mg/dl, with SD for acute appendicitis was 0.598 and probable cases of appendicitis was 0.486. In our study bilirubin provide the highest diagnostic accuracy for acute appendicitis case. Normal inflammatory markers cannot exclude appendicitis, which remains a clinical diagnosis. The presence of history of pain and or signs of peritoneal inflammation which help you in diagnosing acute appendicitis.Conclusions: Hyperbilirubinemia can be a diagnostic marker for acute appendicitis.

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Shelke, Dr Rahul Ramkrishna, and Dr Bahar Dattatray Kulkarni. "A Comparative Study of Open Versus Laparoscopic Appendicectomy in Acute Appendicits." Indian Journal of Applied Research 3, no. 4 (October 1, 2011): 6–8. http://dx.doi.org/10.15373/2249555x/apr2013/125.

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S, Dr Raghupathi. "A Rare Case of Gastric Perforation and Acute Appendicitis." Journal of Medical Science And clinical Research 05, no. 03 (March 9, 2017): 18652–53. http://dx.doi.org/10.18535/jmscr/v5i3.63.

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Sim, TB, and SBS Ooi. "A Fatal Case of Acute Appendicitis." Hong Kong Journal of Emergency Medicine 14, no. 3 (July 2007): 179–82. http://dx.doi.org/10.1177/102490790701400309.

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Appendicitis continues to be the most common acute surgical emergency. We report a fatal case of acute appendicitis, illustrating that the early presentation of appendicitis is non-specific and that serial examination is the key to the diagnosis to avoid a fatal outcome. We also present an evidence-based approach to the diagnosis of acute appendicitis in the emergency department and highlight the pearls and pitfalls of diagnosing acute appendicitis.

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Symeonidis, Nikolaos G., Efstathios T. Pavlidis, Kyriakos K. Psarras, Kalliopi Stavrati, Christina Nikolaidou, Alexandra Marneri, Georgios Geropoulos, Maria Meitanidou, Emili Andreou, and Theodoros E. Pavlidis. "Preoperative Hyponatremia Indicates Complicated Acute Appendicitis." Surgery Research and Practice 2022 (March 31, 2022): 1–5. http://dx.doi.org/10.1155/2022/1836754.

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Introduction. Acute appendicitis is the most common surgical emergency. Early detection of patients with complicated appendicitis leads to prompt surgical management and better outcome. This study investigated the relationship between the severity of acute appendicitis and the presence of preoperative hyponatremia. Materials and Methods. We retrospectively reviewed the medical files of adult patients operated on for acute appendicitis over a 6-year period. Hyponatremia was defined as serum sodium level of ≤135 mEq/L. Patients were classified into complicated appendicitis and noncomplicated appendicitis according to operative findings and/or histopathology reports. Results. A total of 129 patients were identified and included in this study. Complicated appendicitis was found more frequently in female patients and older patients. Hyponatremia was found significantly more frequently in patients with complicated appendicitis ( p < 0.001 ) and also in patients with perforation than without perforation ( p = 0.047 ). Conclusions. The present study demonstrated that preoperative hyponatremia is associated with complicated appendicitis. Serum sodium levels, a routine, low-cost laboratory test, could act as an accessory marker aiding surgeons in earlier identification of gangrenous or perforated acute appendicitis.

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Vanhatalo, Sanja, Eveliina Munukka, Teemu Kallonen, Suvi Sippola, Juha Grönroos, Jussi Haijanen, Antti J. Hakanen, and Paulina Salminen. "Appendiceal microbiome in uncomplicated and complicated acute appendicitis: A prospective cohort study." PLOS ONE 17, no. 10 (October 14, 2022): e0276007. http://dx.doi.org/10.1371/journal.pone.0276007.

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Background Uncomplicated and complicated acute appendicitis seem to be two different forms of this common abdominal emergency. The contribution of appendiceal microbiota to appendicitis pathogenesis has been suggested, but differences between uncomplicated and complicated appendicitis are largely unknown. We compared the appendiceal microbiota in uncomplicated and complicated acute appendicitis. Methods This prospective single-center clinical cohort study was conducted as part of larger multicenter MAPPAC trial enrolling adult patients with computed tomography or clinically confirmed uncomplicated or complicated acute appendicitis. The microbial composition of the appendiceal lumen was determined using 16S rRNA gene amplicon sequencing. Results Between April 11, 2017, and March 29, 2019, 118 samples (41 uncomplicated and 77 complicated appendicitis) were available. After adjusting for age, sex, and BMI, alpha diversity in complicated appendicitis was higher (Shannon p = 0.011, Chao1 p = 0.006) compared to uncomplicated appendicitis. Microbial compositions were different between uncomplicated and complicated appendicitis (Bray-Curtis distance, P = 0.002). Species poor appendiceal microbiota composition with specific predominant bacteria was present in some patients regardless of appendicitis severity. Conclusion Uncomplicated and complicated acute appendicitis have different appendiceal microbiome profiles further supporting the disconnection between these two different forms of acute appendicitis. Study registration ClinicalTrials.gov NCT03257423.

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James, Magnus. "Acute appendicitis." InnovAiT: Education and inspiration for general practice 10, no. 10 (August 15, 2017): 602–7. http://dx.doi.org/10.1177/1755738017720227.

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The appendix was discovered in the 1500s, with the first successful appendectomy being performed in 1735. Throughout the history of medicine, diseases of the appendix have managed to cause confusion among doctors and harm to patients. Morbidity and mortality from appendicitis are improving, but still place a large burden on healthcare. Appendicitis is still one of the commonest surgical emergencies and the aim of this article is to review the incidence, presentation and management of acute appendicitis.

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Nasiri, Mohammad, Hossein Najd Sepas, Alireza Negahi, and Seyed Hamzeh Mousavie. "Evaluation of the Potential Association of Platelet Levels, Mean Platelet Volume and Platelet Distribution Width with Acute Appendicitis." Open Access Macedonian Journal of Medical Sciences 7, no. 14 (July 28, 2019): 2271–76. http://dx.doi.org/10.3889/oamjms.2019.244.

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BACKGROUND: The occurrence and early management of acute appendicitis among children are especially important due to the difficult diagnosis and nonspecific symptoms of the disease. Diagnosis of appendicitis in children is very difficult due to similarity of its symptoms to other diseases, and also its self-limiting nature Platelet indexes such as mean platelet volume (MPV) and platelet distribution width (PDW) have been suggested as a biomarker of inflammation. AIM: Therefore, we examined the association of MPV and PDW with acute appendicitis in children. METHODS: This cross-sectional study was conducted on 464 patients with suspected acute appendicitis under the age of 18 years referred to the specialised hospitals of the ten studied provinces between October 2014 and October 2015. All data obtained regarding patient's lab tests, i.e. platelet count, MPV and PDW and also radiological studies and surgical reports were gathered in datasheets and analysed to evaluate the potential association of platelet levels, mean platelet volume (MPV) and platelet distribution width (PDW) with acute appendicitis RESULTS: Our results showed that the MPV was significantly higher in acute appendicitis in comparison to perforated appendicitis as well as acute gangrenous appendicitis. PDW was significantly higher in acute appendicitis in comparison to perforated appendicitis and acute gangrenous appendicitis. The current project indicated that PDW < 10.05 had a sensitivity of 35% and specificity of 75%, platelet count < 229500 had a sensitivity of 24% and specificity of 75% and MPV < 8.95 had a sensitivity of 70% and specificity of 71%. CONCLUSION: Our study suggested that platelet indexes such as MPV and PDW could significantly correlate with acute appendicitis in pediatric patients. Hence, we believe that both MPV and PDW could use as a simple and low-cost lab test for diagnosing acute appendicitis. Also, this study revealed that the MPV lower than 8.95 could be a novel index for diagnosing acute appendicitis with sensitivity of 70% and specificity of 71%.

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Duda, Jeremy B., Miranda L. Lynch, Shweta Bhatt, and Vikram S. Dogra. "Computed Tomography Mimics of Acute Appendicitis: Predictors of Appendiceal Disease Confirmed at Pathology." Journal of Clinical Imaging Science 2 (December 4, 2012): 73. http://dx.doi.org/10.4103/2156-7514.104306.

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Purpose: Imaging and pathology findings are used to analyze the capability of computed tomography (CT) to distinguish between acute appendicitis and radiological mimickers. Materials and Methods: A retrospective review of 5861 patients undergoing abdominopelvic CT from 2000 to 2008 for suspicion of acute appendicitis was performed. Appendix diameter, surrounding inflammation, appendicolith, and location were assessed. Only those cases were included where patients underwent surgery for acute appendicitis on CT findings. Pathology specimens were examined and those indicative of acute appendicitis were identified. Statistical analysis was performed to correlate pathology and CT signs. Results: A total of 969 of the 5681 patients were included in the study. Acute appendicitis was verified in 870/969 (89%) cases, while 99/969 (11%) demonstrated either chronic findings (i.e., fibrosis [32%], granulomatous disease [16%], lymphoid hyperplasia [11%]) or no abnormality. In regression models, appendiceal diameter >7 mm (odds ratio [OR] = 3.98, P < 0.0001) and mesenteric fat stranding (OR = 6.04, P < 0.0001) were associated with acute appendicitis. Nearly 87% (754/870) of acute appendicitis cases showed both signs on CT, compared with 53% (52/99) of those with other pathologic finding (P < 0.0001). In cases with non-appendicitis findings, 39% (39/99) had only one of these signs compared with 13% (112/870) of those with acute appendicitis (P < 0.0001). Conclusion: Diseases of the appendix other than acute appendicitis may manifest with isolated radiological findings and should be considered as part of the differential diagnosis in cases of borderline acute appendicitis.

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VAN LAECKE A, DE RYCK F, VAN GANSE W, and VAN AVERMAET S. "Acute appendicitis?" Tijdschrift voor Geneeskunde 55, no. 10 (January 1, 1999): 736–39. http://dx.doi.org/10.2143/tvg.55.10.5000446.

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Walter, Kristin. "Acute Appendicitis." JAMA 326, no. 22 (December 14, 2021): 2339. http://dx.doi.org/10.1001/jama.2021.20410.

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Horton, Karen M. "Acute Appendicitis." Critical Reviews in Computed Tomography 44, no. 1 (January 2003): 1–19. http://dx.doi.org/10.3109/10408370390808432.

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Jamali, Khawar Saeed, Humaid Ahmed, Muhammad Jawed, and Ubedullah Shaikh. "ACUTE APPENDICITIS." Professional Medical Journal 22, no. 12 (December 10, 2015): 1601–5. http://dx.doi.org/10.29309/tpmj/2015.22.12.845.

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Objectives: The objective of this study was to compare the efficacy of ClinicalEvaluation and modified Alvarado scoring system in diagnosing acute appendicitis. StudyDesign: Cross sectional study. Place and Duration of Study: This study was conducted atSurgical Unit III of Civil Hospital Karachi from May 2010 to October 2010. Methodology: Thisstudy consisted of eighty patients. Patients were divided in two groups. Group A for completeclinical evaluation comprising of 40 patients and Group B for modified Alvarado scoring systemcomprising of 40 patients. Inclusion criteria were all patients presenting with RIF pain, nausea,vomiting, fever and/or anorexia, diagnosed as having acute appendicitis preoperatively andundergoing emergency appendectomy during this period, age >12 years and both gender.Exclusion criteria included not willing for surgery, General anesthesia problem, pregnant femalepatients and those who did not give written consent. Results: A total of 80 patients were includedin the study, placed alternatively into two groups of 40 patients each with majority being male(n = 61, 76.3%). The mean age was 22.46 years. The positive predictive value for patients ofGroup A was 92.5% while for Group B was 77.5%. When diagnostic accuracy was compared onthe basis of Gender for the two groups, the positive predictive value for male patients of GroupA and B was 90.09% and 89.28% respectively, but for females the positive predictive valueof Group A and B was 100% and 50% respectively. Conclusion: We conclude that modifiedAlvarado score can be used safely and effectively in diagnosing acute appendicitis in adultmales especially as the score increases from seven to nine.

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Saeed, Zahid. "ACUTE APPENDICITIS;." Professional Medical Journal 21, no. 06 (December 10, 2014): 1139–43. http://dx.doi.org/10.29309/tpmj/2014.21.06.2246.

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Background: Acute appendicitis is the commonest cause of acute abdomen presenting in emergency room, which is mainly diagnosed on clinical grounds. Objective: To determine the diagnostic accuracy in patient of acute appendicitis and to review the pathological diagnosis. Material and Method: A retrospective study was conducted at PNS SHIFA hospital at Karachi; from May 2012 to April 2013. A total of 120 patients were included in the study who presented with acute abdomen and clinically diagnosed as acute appendicitis. Emergency appendectomy was done in all consecutive subjects and intra operative finding along with histo-pathological reports were compared with clinical diagnosis. Results: A total of 120 patients were included in the study who underwent appendicectomy during this period. The majority of our patients were in the age group between 15-30 years (66.5%) and presented within 24 h of onset of symptoms. The most common symptoms were abdominal pain (100%), vomiting (57.4%) and anorexia (49.0%). Pyrexia was noted in 41.0%.Localized abdominal tenderness with positive release sign was mainly present. The most common incision was gridiron (57.2%) followed by Lanz (37.3%) and in remaining Rutherford Morrison incision was made. Acute appendiceal inflammation and gangrenous appendicitis was present in 67% and 13%, respectively. The perforation rate was 5.0% and there was a direct correlation with time of presentation. There were no patients with carcinoid tumour or adenocarcinoma. Parasites and other associated conditions were seen in 3 % of cases. On the basis of histo-pathological report, 84% were found to have acute appendicitis with negative appendicectomy rate of 16.0%. Conclusions: Clinical surgical skill is good enough to diagnose acute appendicitis but auxiliary diagnostic tools can help to elevate the diagnostic accuracy,but these are not 100% accurate and at times may not be available.So clinial good judgement is essential for proper diagnosis and that can be confirmed by histopathology report.

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Farid, Javeria, Rizwanullah Junaid Bhambhro, and Sohail Soomro. "ACUTE APPENDICITIS." Professional Medical Journal 23, no. 03 (March 10, 2016): 241–45. http://dx.doi.org/10.29309/tpmj/2016.23.03.1465.

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Objectives: To determine the clinical presenting pattern and postoperativecomplications of acute appendicitis. Study design: Observational and cross-sectional study.Setting: Isra university hospital Hyderabad. Period: 7 months. Methodology: All the patientsabove 12 years of age and both genders male/female after diagnosis of acute appendicitishad integrated in the study. Complete clinical pattern and postoperative complications hadrecorded. Results: Symptoms/sign nausea, vomiting, anorexia, rebound tenderness, fever,constipation, diarrhea and leukocytosis were noted with the percentage 98.0%, 65.0%, 95.0%,90.0%, 85.0%, 58.0%, 30.0% and 89.0% respectively. Paraumblical pain was noted in 50.0%of the cases, right iliac fossa pain was in the 99.0%, epigastric pain was seen in 61.0% and theother abdominal pain was noted in the 39.0%. Postoperative complications found in 33.0% ofthe cases and majority was seen wound infection. Conclusion: In the conclusion of this studyclinical features nausea, vomiting, anorexia, rebound tenderness, fever, and leukocytosis wereseen as most common and the most important postoperative complication is infection whichprobably created with the uncompleted sterilization.

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Cudworth, Michael. "Acute Appendicitis." Reviews at LibraryOfMedicine.com 1, no. 1 (October 13, 2014): 11. http://dx.doi.org/10.16963/rlom.v1i1.2.

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Schuveiller, Michael, and Robin Stading. "Acute Appendicitis." Journal of Diagnostic Medical Sonography 20, no. 6 (November 2004): 426–30. http://dx.doi.org/10.1177/8756479304269947.

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Triadafilopoulos, George. "Acute appendicitis." Gastrointestinal Endoscopy 54, no. 5 (November 2001): 624. http://dx.doi.org/10.1067/mge.2001.118138.

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Takhar, Arunjit S., Meera Patel, Omer Al-Taan, and James A. Stephenson. "Acute Appendicitis." InnovAiT: Education and inspiration for general practice 4, no. 4 (December 6, 2010): 204–10. http://dx.doi.org/10.1093/innovait/inq151.

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Simpson, John, and JH Scholefield. "Acute Appendicitis." Surgery (Oxford) 20, no. 7 (July 2002): 153–57. http://dx.doi.org/10.1383/surg.20.7.153.14395.

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Simpson, John, and John H. Scholefield. "Acute appendicitis." Surgery (Oxford) 23, no. 6 (June 2005): 213–16. http://dx.doi.org/10.1383/surg.23.6.213.66556.

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Watkins, Jean. "Acute appendicitis." Practice Nursing 17, no. 10 (October 2006): 497. http://dx.doi.org/10.12968/pnur.2006.17.10.21947.

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Garst, Geoffrey C., Ernest E. Moore, Monisha N. Banerjee, David K. Leopold, Clay Cothren Burlew, Denis D. Bensard, Walter L. Biffl, Carlton C. Barnett, Jeffrey L. Johnson, and Angela Sauaia. "Acute appendicitis." Journal of Trauma and Acute Care Surgery 74, no. 1 (January 2013): 32–36. http://dx.doi.org/10.1097/ta.0b013e318278934a.

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Simpson, John, and John H. Scholefield. "Acute appendicitis." Surgery (Oxford) 26, no. 3 (March 2008): 108–12. http://dx.doi.org/10.1016/j.mpsur.2008.01.003.

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Froggatt, Paul, and Chris Harmston. "Acute appendicitis." Surgery (Oxford) 29, no. 8 (August 2011): 372–76. http://dx.doi.org/10.1016/j.mpsur.2011.05.016.

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Journal articles on the topic 'Appendicite acuta'

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