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Related Concept Videos

Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

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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:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
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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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Acute Pancreatitis II: Clinical Manifestations and Management01:30

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Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Acute Pancreatitis I: Introduction01:27

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Pancreatitis is inflammation of the pancreas, an organ located behind the stomach. It can be either acute or chronic.
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Murine Appendectomy Model of Chronic Colitis Associated Colorectal Cancer by Precise Localization of Caecal Patch
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Acute appendicitis in elderly during Covid-19 pandemic.

G Lisi1, M Campanelli2, M R Mastrangeli3

  • 1Department of Surgery, Sant'Eugenio Hospital, Piazzale dell'Umanesimo 10, 00144, Rome, Italy. giolimas06@yahoo.it.

International Journal of Colorectal Disease
|May 28, 2021
PubMed
Summary

The COVID-19 pandemic delayed diagnosis and increased complicated appendicitis in elderly patients, leading to more surgical conversions. This highlights challenges in managing acute appendicitis in older adults during public health crises.

Keywords:
Acute appendicitisAppendectomyCovid-19ElderlyLaparoscopy

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Area of Science:

  • Geriatric Surgery
  • Emergency Medicine
  • Epidemiology

Background:

  • Hospital access restrictions during the pandemic led to delayed treatment for non-traumatic abdominal emergencies.
  • Evidence-based recommendations for managing acute appendicitis in elderly patients during the pandemic were lacking.

Purpose of the Study:

  • To assess the impact of the pandemic on the management of acute appendicitis in patients over 68 years old.
  • To compare surgical outcomes and complication rates before and during the pandemic.

Main Methods:

  • Retrospective analysis of patients over 68 who underwent appendectomy between February 2020 and December 2020.
  • Comparison with a similar cohort from the pre-pandemic period.
  • Data included surgical approach, hospital stay, and post-operative complications.

Main Results:

  • During the pandemic, 59.3% of cases had complicated appendicitis, compared to 26.5% pre-pandemic.
  • Laparoscopic appendectomy rates decreased, with increased conversions to laparotomy (22.3% vs 14.7%).
  • Mean hospital stay increased to 5.64 days during the pandemic from 4.21 days prior.

Conclusions:

  • Pandemic conditions contributed to delayed diagnosis in elderly patients with acute appendicitis.
  • An increase in complicated appendicitis was observed, evidenced by higher rates of conversion to laparotomy.