Appendicitis in children aged 13 years and younger

Article Abstract:

A study of 230 children aged 13 years or younger who underwent surgery for acute appendicitis is discussed. The majority of patients were poor, and many had waited for four to eight hours in an overcrowded emergency room. Two-thirds were Hispanic. Patients underwent surgery as soon as possible, and those whose appendix seemed likely to be perforated (ruptured) began treatment with antibiotics when first seen. If no perforation was found during surgery, antibiotics were discontinued. If perforation had occurred, surgical drains (for removing fluid from the abdominal cavity) were inserted, and additional measures were taken. The overall incidence of perforated appendicitis was 47 percent, with patients six and younger having a higher rate (61 percent), and those two and under, still higher (67 percent). At this Los Angeles county hospital, the number of children with appendicitis increases each year, as does the incidence of perforation. Pain in the lower right-hand region of the abdomen, and nausea and vomiting, were the most common symptoms among these children, and elevated temperatures and white blood cell counts were also found. No patient died, and two (one with a perforated appendix, one without) required reoperation because of abscesses. The high rates of appendicitis, and of perforation among younger children, are discussed. In most cases, patients had experienced symptoms for a considerable time before receiving treatment. An advantage of the long in-hospital waiting periods may have been the opportunity for preoperative fluid and antibiotic therapy. In spite of the high incidence of perforation among this group, the patients' recovery after surgery was rapid. The preoperative care and surgical approach used undoubtedly contributed significantly to this positive outcome. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Methods, Pediatric diseases, Children, Diseases

---

Treatment of rectal carcinoid tumors

Article Abstract:

Rectal carcinoid is a tumor that has a low malignant potential and is less likely than most cancers to infiltrate the rectal wall. Some carcinoids do spread, and their potential malignancy is not uniform. Often, carcinoids are found when they are small, and the surgical decision may be difficult: to remove only the tumor, or to perform more extensive surgery. When making surgical decisions, not only the histologic findings (microscopic study of tissue) but also the size and shape of the tumor may be considered. The clinical, pathologic and outcome information obtained in treatment of 24 patients with rectal carcinoid tumors is presented. One tumor was 8 centimeters, about 2 inches, in size; 19 were under 1 cm, and four were between 1 and 2 cm. It was found that all tumors less than 2 cm in diameter did not have invasion into the muscular layer of the rectum, nor distant spread to the lymph nodes. The exception was one tumor which was an atypical carcinoid; this tumor had both invasion and spread. The carcinoid that was over 2 cm had both lymphatic involvement and invasion of the urinary bladder. The carcinoid tumors that were less than 2 cm in diameter were removed locally by either wedge resection or polypectomy; the atypical carcinoid and the tumor larger than 2 cm were treated with more extensive surgery. All patients had a good prognosis with no tumor recurrence and no new metastasis; postoperative follow-up ranged from 6 months to 14 years. It is concluded that typical carcinoid tumors smaller than 2 cm can be treated with local excision. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prognosis, Carcinoid, Carcinoid tumor, Gastrointestinal tumors

---

The consequences of current constraints on surgical treatment of appendicitis

Article Abstract:

This study examines the effect of changes in how patients are currently evaluated before being sent to the surgeon with a diagnosis of appendicitis. Since cost-cutting measures have gone into effect, the rate of patients with later stages of the disease seeking surgery has increased. As a result, the number of patients requiring a prolonged period of hospitalization has also lengthened. The rate of postsurgical complications has also risen. The authors state that this deterioration in patient care and the failure at cost containment comes from not performing surgery which is known to be effective. The authors note that surgeons understand the value of performing a small number of appendectomies which will, at the time of surgery, prove unnecessary. The authors conclude that the gatekeepers (business officers) of hospitals must accept certain hospitalizations which prove to be unnecessary in order to protect others.

Hospitalization, Hospital care

Similar abstracts:

• Abstracts: Alpha linolenic acid in cholesterol esters: a marker of alphalinolenic acid in take in newborns. Enhancing immunity by dietary consumption f a probiotic lactic acid bacterium (Bifidobacterium lactis HN019): optimization and definition of cellular immune responses
• Abstracts: Hepatitis A vaccine. Argatroban for treatment of heparin-induced thrombocytopenia. Twinrix: a combination hepatitis A and B vaccine
• Abstracts: Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program
• Abstracts: Pressure ulcers among the elderly. Management of drug therapy in the elderly. Lp(a) lipoprotein, vascular disease, and mortality in the elderly
• Abstracts: Recommendations for the prevention of malaria among travelers. The spread of chloroquine-resistant malaria in Africa: implications for travelers

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.