Paper Search Console

Home Search Page About Contact

Journal Title

Title of Journal: Pediatr Surg Int

Search In Journal Title:

Abbravation: Pediatric Surgery International

Search In Journal Abbravation:

Publisher

Springer-Verlag

Search In Publisher:

DOI

10.1007/s00383-009-2331-0

Search In DOI:

ISSN

1437-9813

Search In ISSN:
Search In Title Of Papers:

Do not rush into operating and just observe active

Authors: Yusuf Hakan Çavuşoğlu Derya Erdoğan Ayşe Karaman Mustafa K Aslan İbrahim Karaman Özden Ç Tütün
Publish Date: 2009/01/28
Volume: 25, Issue: 3, Pages: 277-282
PDF Link

Abstract

The aim of this study was to determine whether the admission and active observation of children where the diagnosis of acute appendicitis is uncertain is a safe and effective way to improve the diagnostic accuracy of appendicitis and safely reduce the incidence of negative laparotomies without increasing complicationsA total of 569 patients were included in the study The mean age was 95 ± 32 range 11–17 years The number of patients directly operated on with a diagnosis of appendicitis was 186 32 from the total of 575 while 389 patients 68 were observed in the surgical ward as the examination and/or investigation findings were equivocal Of the 383 patients admitted for observation 173 45 were operated on with a suspicion of appendicitis after 144 ± 67 h while 210 55 were discharged after 11 ± 12 days as there seemed to have no surgical problem Our total negative appendectomy rate was 4 14/350 and total perforation rate was 374 131/350 The patients operated on directly and those operated on after observation were similar and there was no difference for the preoperative duration of symptom histopathological diagnosis postoperative complication rate postoperative inpatient days and hospital charges Total hospitalization duration was significantly longer and the hospital charges significantly higher in the negative appendectomy groupBoth the features and results and the complication rates and costs of the group operated on after observation were the same as the directly operated on group However patients undergoing a negative appendectomy stayed as inpatients longer than only observation patients with higher treatment charges We could therefore decrease the negative appendectomy rate the associated cost and duration of hospitalization without causing extra complications if we observe and investigate patients with right lower quadrant pain with a doubtful diagnosis and did not operate on them directly

Keywords:

References

.
Search In Abstract Of Papers:
Other Papers In This Journal:
  1. Low mortality in necrotizing enterocolitis associated with coagulase-negative Staphylococcus infection
  2. Low mortality in necrotizing enterocolitis associated with coagulase-negative Staphylococcus infection
  3. Chronic bilious vomiting in children in developing countries due to high bowel obstruction: not always malrotation or tuberculosis
  4. Implantable versus cuffed external central venous catheters for the management of children and adolescents with acute lymphoblastic leukaemia
  5. Effect of insulin-like-growth factor and its receptors regarding lung development in fetal mice
  6. Effect of testicular ischemia-reperfusion on recruitment of neutrophils, E-selectin expression and germ cell apoptosis in the contralateral testis in a rat
  7. Effect of testicular ischemia-reperfusion on recruitment of neutrophils, E-selectin expression and germ cell apoptosis in the contralateral testis in a rat
  8. Expression of vasoactive mediators during mechanical ventilation in nitrofen-induced diaphragmatic hernia in rats
  9. Improvement in the quality of life using both Bianchi’s procedure and the closure of a jejunostomy in a case with short bowel syndrome
  10. Combined free autologous auricular cartilage and fascia lata graft repair for a recurrent tracheoesophageal fistula
  11. Influence of hypoxia-dependent factors on the progression of neuroblastoma
  12. The impact of iatrogenic gastroschisis on pulmonary maturation in the fetal rabbit models of congenital diaphragmatic hernia
  13. Intrathoracic and intraabdominal locations of a cystic benign tumor: congenital etiology due to embryological diaphragm development?
  14. “Pouch colon patch graft”—an alternative treatment for congenital short colon
  15. Pure esophageal atresia with no gap and associated intra-abdominal calcification
  16. An in vitro study of silicone migration from intravenous fluid tubing
  17. Usage of 64-detector-row spiral computed tomography volumetry in preoperative volume prediction in living donor liver transplantation in children
  18. Is adrenomedullin involved in the pathophysiology of persistent pulmonary hypertension of the newborn?
  19. Novel use of porcine urinary bladder matrix for pediatric pilonidal wound care: preliminary experience
  20. An unexpected diagnosis in children with male phenotype and bilateral nonpalpable gonad: congenital adrenal hyperplasia with female genotype
  21. Intestinal perforation secondary to ingested foreign bodies: a single-center experience with 38 cases
  22. Role of penile biometric characteristics on surgical outcome of hypospadias repair
  23. Spontaneous perforation of the biliary tract and portal vein thrombosis in infancy
  24. Small-bowel continuity: A crucial factor in determining survival in gastroschisis
  25. Laparoscopic resection of intra-abdominal extralobar pulmonary sequestration
  26. Prehospital predictors of risk for pelvic fractures in pediatric trauma patients
  27. Visceral coverage with absorbable mesh followed by split-thickness skin graft in the treatment of ruptured giant omphalocele
  28. Severe hyperphosphatemia after administration of sodium-phosphate containing laxatives in children: case series and systematic review of literature
  29. Neonatal pneumoperitoneum: a critical appraisal of its causes and subsequent management from a developing country
  30. Congenital diaphragmatic hernia in CHARGE syndrome
  31. Idiopathic biliary perforation in a 10-year-old boy
  32. Duplicated proctodeum
  33. To drain or not to drain: an analysis of abscess drains in the treatment of appendicitis with abscess
  34. Critical presentation of pleuropulmonary blastoma
  35. Congenital pyloric atresia and associated anomalies
  36. The area and attachment abnormalities of the gubernaculum in patients with undescended testes in comparison with those with retractile testes
  37. Genetics and developmental biology of oesophageal atresia and tracheo-oesophageal fistula: lessons from mice relevant for paediatric surgeons
  38. Letter to the Editor regarding the article “Anorectal malformations and neurospinal dysraphism: is this association a major risk for continence?”
  39. Perforated appendicitis presenting as appendicoumbilical fistula
  40. A complicated case of bilateral cystic nephroma in a 16-month-old boy
  41. Translation and cultural adaptation of the Hirschsprung’s Disease/Anorectal Malformation Quality of life Questionnaire (HAQL) into Swedish
  42. Efficacy of the circulatory management of an antenatally diagnosed congenital diaphragmatic hernia: outcomes of the proposed strategy
  43. Thoracoscopic repair of congenital diaphragmatic hernia: two centres’ experience with 60 patients
  44. Successful complete resection of Ewing sarcoma arising from the bladder in a 10-year-old boy after chemotherapy
  45. Indications for thoracoscopic repair of congenital diaphragmatic hernia in neonates
  46. Neuroblastoma detected by mass screening: the Tumor Board’s role in its treatment
  47. Three-dimensional liver model based on preoperative CT images as a tool to assist in surgical planning for hepatoblastoma in a child
  48. Three-dimensional liver model based on preoperative CT images as a tool to assist in surgical planning for hepatoblastoma in a child
  49. Duodenal duplication with bile duct obstruction and keratinaceous casts
  50. Beneficial effects of Etanercept on experimental necrotizing enterocolitis
  51. Blockade of the renin–angiotensin system prevents acute and immunologically relevant colitis in murine models
  52. Bowel function after surgery for anorectal malformations in patients with tethered spinal cord
  53. PAF antagonist BN-52021 reduces intercellular adhesion molecule-1 expression and oxidative stress in rats with reperfusion damage due to unilateral testicular torsion
  54. Practice variability exists in the management of high-grade pediatric pancreatic trauma
  55. Prenatal diagnosis of cloacal malformations
  56. Silencing of the MYCN gene by siRNA delivered by folate receptor-targeted liposomes in LA-N-5 cells
  57. HoxB2, HoxB4 and Alx4 genes are downregulated in the cadmium-induced omphalocele in the chick model
  58. Surfactant protein-D attenuates the lipopolysaccharide-induced inflammation in human intestinal cells overexpressing toll-like receptor 4
Search Result: