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Appendicitis-I: Introduction01:22

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The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
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Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
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Chronic pharyngitis refers to persistent inflammation of the pharyngial mucosa.
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This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
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Streptococcal Pharyngitis and Appendicitis in Children.

Jason W Nielsen1,2,3, Stuart A Abel3, Brian Kenney1,2

  • 11 Nationwide Children's Hospital, Columbus, OH, USA.

Clinical Pediatrics
|February 1, 2017
PubMed
Summary

Testing for streptococcal (strep) pharyngitis in children with appendicitis-like symptoms is associated with lower appendicitis rates and higher negative appendectomy rates. Concurrent strep pharyngitis and appendicitis is rare.

Keywords:
appendicitischildrenstreptococcal pharyngitis

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Area of Science:

  • Pediatric Emergency Medicine
  • Infectious Diseases
  • Surgical Diagnosis

Background:

  • Abdominal pain is a common presenting symptom in children, often mimicking appendicitis.
  • Pharyngitis, particularly streptococcal (strep) pharyngitis, can present with symptoms that overlap with appendicitis.
  • Understanding the relationship between strep pharyngitis and appendicitis is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To investigate the association between appendicitis-like symptoms and concurrent diagnosis of streptococcal pharyngitis.
  • To evaluate the impact of strep pharyngitis testing on appendicitis diagnosis and surgical outcomes.

Main Methods:

  • Retrospective review of 1572 pediatric patients undergoing ultrasound for appendicitis in 2013.
  • Identification of 207 patients who underwent both appendicitis ultrasound and strep pharyngitis testing.
  • Comparison of demographic and outcome data between patients who were tested for strep pharyngitis and those who were not.

Main Results:

  • Strep testing was more frequent in younger children (mean age 8.26 years).
  • Of 207 tested patients, 3.9% had appendicitis and 16.9% tested positive for strep pharyngitis; no concurrent cases were found.
  • The negative appendectomy rate was significantly higher in the strep-tested group (38.5%) compared to the non-tested group (7.7%).
  • Appendicitis rates were lower in the strep-tested group (3.8%) versus the non-tested group (20%).

Conclusions:

  • Testing for strep pharyngitis in pediatric patients with appendicitis-like symptoms is linked to younger age, lower appendicitis rates, and increased negative appendectomy rates.
  • Concurrent appendicitis and strep pharyngitis is uncommon.
  • In patients with symptoms warranting strep testing, appendicitis is less likely, and surgical intervention may lead to higher rates of negative appendectomies.