Buradasınız

Anasayfa » Content

Management Strategies of Appendix with Mild Inflammation

Hafif inflamasyonlu apendisitte tedavi yaklaşımları

Journal Name:

  • Abant Tıp Dergisi

Publication Year:

  • 2014

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objective: In this study, we examined the cases with mild acute appendicitis and their treatments with different moda-lities and their follow up. Method: 45 patients were studied between August 2008 and January 2010, with further follow-up for 1 year. The patients were randomly allocated into three groups by systematic random sampling with an equal size of 15 to maintain balan-ce. First group was appendectomy group, second was antibi-otic group and third group was follow up (no treatment) group. Results: The median age of the patients was 25 (18-52) years. 34 (75.6%) were women and 11 (24.4%) were men. The mean white blood cell count was 7952±1698 /uL (4800-10700). The mean appendix wall thickness at ultrasonog-raphy was 5.46±0.35 (5,0-6,0) mm. There were no statistical difference detected between groups in age of patients, sex, white blood cell count and ultrasonography results (p=0.361, 0.894, 0.708 and 0.867). Of the patients who underwent surgery had proven appendicitis at histological examination. Two patients treated with antibiotics were readmitted with recurrent appendicitis, one patients after 2 weeks of treat-ment and one patient after 2 days of treatment and were subsequently operated in the second admission. However, no chronic findings were noted at histopathological examina-tion. Conclusion: Most of the early acute appendicitis, there is no need for appendectomy.
Bookmark/Search this post with
Abstract (Original Language): 
Amaç: Akut apandisit tedavisi halen klinik bir tartışmadır. Bu çalışmada, erken akut apandisit tanısı alan hastalarda değişik tedavi yaklaşımlarını ve bunların takiplerini tartış-mayı amaçladık. Yöntem: Ağustos 2008 ve Ocak 2010 tarihleri arasında erken dönem akut apandisit tanısı konulan 45 hasta çalış-maya dahil edildi ve bu hastaların 1 yıllık takip sonuçları incelendi. Bu hastalar 3 gruba randomize edildi. Birinci gruba apendektomi yapıldı, ikinci gruba antibiyotik tedavisi uygulandı ve üçüncü grup ise sadece izlendi. Bulgular: 45 hastanın ortanca yaşı 25 (18-52) idi. 34 hasta kadın (%75.6) ve 11 hasta (%24.4) erkek idi. Ortalama beyaz küre sayısı 7952±1698 /uL (4800-10700) olarak izlendi. Ultrasonografide ortalama apendiks duvar kalınlığı 5.46±0.35 (5,0-6,0) mm olarak tespit edildi. Gruplar arasın-da yaş, cinsiyet, beyaz küre sayısı ve ultrasonografi sonuçla-rı açısından farklılık yoktu (p=0.361, 0.894, 0.708 ve 0.867). Cerrahi yapılan grubun hepsinde patoloji sonuçları akut apandisit olarak geldi. Antibiyotik tedavi grubundan 2 hasta daha sonra tekrarlayan karın ağrısı şikayeti ile, biri 2 hafta sonra, diğeri ise 2 gün sonra tekrar hastaneye başvurdu ve bu hastalara apendektomi yapıldı, ancak patoloji raporla-rında kronik apandisit bulgusu saptanmadı. Sonuç: Apendektomi erken akut apandisit düşünülen hasta-ların çoğunda gerekli değildir.
FULL TEXT (PDF): 
PDF icon arastirmax-management-strategies-appendix-mild-inflammation.pdf
  • 2
120
123
  • English

REFERENCES

References: 

1. Mosegaard A, Nielsen OS. Interval appen-dectomy: A retrospective study. Acta Chir Scand 1979;145:109–111.
2. Adams ML. The medical management of acute appendicitis in a non-surgical environ-ment: a retrospective case review. Mil Med 1990;155:345–347.
3. Butler C. Surgical pathology of acute appen-dicitis. Hum Pathol. 1981;12:870-878.
4. Fitz RH. Perforating inflammation of the vermiform appendix. Am J Med Sci 1886; 92:321–346.
5. McBurney C. Experiences with early operati-ve interference in cases of disease of the ver-miform appendix. N Y Med J 1889; 50:1676–1684.
6. Harrington JL. The vermiform appendix: its surgical history. Contemp Surg 1991; 39:36–44.
7. McPherson A, Kinmonth J. Acute appendici-tis and the appendix mass Br J Surg. 1945;32:365–370.
8. Coldrey E. Five years of conservative treat-ment of acute appendicitis. J Int Coll Surg 1959;32:255–261.
9. Anonymous. Combined traditional Chinese and western medicine in acute appendicitis. Chin Med J 1977;3:266–269.
10. Malik AA, Bari SU. Conservative manage-ment of acute appendicitis. J Gastrointest Surg 2009; 13: 966–970.
11. Hansson J, Korner U, Khorram-Manesh A, Solberg A, Lundholm K. Randomized clinical trial of antibiotic therapy versus appendi-cectomy as primary treatment of acute appen-dicitis
in unselected patients. Br J Surg 2009; 96: 473–481.
12. Styrud J, Eriksson S, Nilsson I et al. Appen-dectomy versus antibiotic treatment in acute appendicitis. a prospective multicenter rando-mized controlled trial. World J Surg 2006; 30: 1033–1037.
13. Bagi P, Dueholm S, Karstrup S. Percutane-ous drainage of appendiceal abscess. An alter-native to conventional treatment. Dis Colon Rectum 1987; 30: 532–535.
14. Adams ML. The medical management of acute appendicitis in a nonsurgical environ-ment: a retrospective case review. Mil Med 1990; 155: 345–347.
15. Butsch DW, Jothi R, Butsch WL, Butsch JL. Recurrent appendicitis: Fact not fallacy. Postg-rad Med 1973;54:132-137.
16. Luckmann R. Incidence and case fatality rates for acute appendicitis in California: A population based study of the effects of age. Am J Epidemiol 1991;2:323-330.
17. Amland PF, Skaane P, Ronningen H, et al. Ultrasonography and parameters of inflamma-tion in acute appendicitis: A comparison with clinical findings. Acta Chir Scand 1989;155:185-189.
18. Heler MB, Skolnick ML. Ulrasound docu-mentation of spontenously resolving appendi-citis. Am J Emerg Med 1993;11:51-53.
19. Jeffrey RB Jr, Laing FC, Townsend RR. Acute appendicitis: Sonographic criteria based on 250 cases. Radiology 1988;167:327-329.
20. Migraine S, Atri M, Bret Pm, et al. Sponte-nously resolving acute appendicitis: Clinical and sonographic documentation. Radiology 1997;205:55-58.
21. Kieshenbaum M, Mishra V, Kuo D, Kaplan G. Resolving appendicitis: Role of CT. Abdom Imaging 2003;28:276-279.
22. Mason RJ. Surgery for appendicitis: Is it necessary? Surg Infections 2008;9:481-489.
23. Oeutsch AA, Shani N, Reiss R. Are some appendicectomies unnecessary? An analysis of 319 white appendices. J R Coll Surg Edinb 1983;28:35–40.
24. Pieper R, Kager L, Nasman P. Acute appen-dicitis: a clinical study of 1018 cases of emer-gency appendectomy. Acta Chir Scand 1982;148:51–62.

Thank you for copying data from http://www.arastirmax.com