摘要 :
The appendix is the smallest, nonfunctional segment of gastrointestinal tract. Appendicitis is the most common surgical emergency, but the clinical diagnosis often is not straightforward and can be very challenging. Delayed diagno...
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The appendix is the smallest, nonfunctional segment of gastrointestinal tract. Appendicitis is the most common surgical emergency, but the clinical diagnosis often is not straightforward and can be very challenging. Delayed diagnosis can lead to increased morbidity due to such complications as appendiceal perforation, abscess formation, sepsis, peritonitis, bowel obstruction, and even death. Useful diagnostic modalities include ultrasonography and CT. Prior to making the diagnosis of appendicitis, one should be able to identify normal appendix. This review article is designed to permit the radiologist to 1) identify the normal appendix on nonenhanced and enhanced CT scans; 2) recognize pitfalls, artifacts, and mimics of the appendix; and 3) detect both the obvious and the subtle findings of appendicitis and its complications.
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摘要 :
Intraluminal gas and an appendiceal diameter measuring up to 10 mm on CT are common findings of a normal appendix. Recognition of a normal appendix is required to exclude appendicitis. An enlarged appendix with periappendiceal inf...
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Intraluminal gas and an appendiceal diameter measuring up to 10 mm on CT are common findings of a normal appendix. Recognition of a normal appendix is required to exclude appendicitis. An enlarged appendix with periappendiceal inflammation is the most common finding of acute appendicitis. Fat stranding may present in different patterns depending on location of the appendix.
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Aim: The present study was conducted to determine the genes with common expression in blood and appendix tissue samples in order to introduce them as possible diagnostic biomarkers. Background: Diagnosis of acute appendicitis (AA)...
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Aim: The present study was conducted to determine the genes with common expression in blood and appendix tissue samples in order to introduce them as possible diagnostic biomarkers. Background: Diagnosis of acute appendicitis (AA) without applying computed tomographytomography (CT), subjecting the patient to significant radiation, can be surprisingly difficult. Blood circulation may have conscious alterations in its RNA, protein, or metabolite composition. Methods: The genes related to appendix tissue and blood samples of the patients with AA were extracted from public databases. Fold change (FC) ≥ 2 in blood and FC ≥ 5 in appendix tissue samples were considered to screen differentially expressed genes (DEGs). A protein-protein interaction network was organized using the search tool for retrieval of interacting genes and proteins (STRING) database as a plugin of Cytoscape software version 3.6.0. The main genes were enriched by DAVID Bioinformatics Resources to find the related biochemical pathways. Results: Among the DEGs in blood and appendix tissue samples, C-X-C motif chemokine receptor 1(CXCR1), leukocyte immunoglobulin-like receptor A3 (LILRA3), low-affinity immunoglobulin gamma Fc region receptor III (FCGR3), and superoxide dismutase 2(SOD2) were common in both sources. CXCR1 was found as only hub gene upregulated in both blood and tissue of the patients with AA compared to controls and those with other abdominal pain. Conclusion: CXCR1, FCGR3, LILRA3, and SOD2 were determined as a suitable possible biomarker panel for diagnosis of AA disease.
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Computed tomography (CT) has become a critical tool in the diagnostic algorithm for acute appendicitis. For the clinician, history and physical examination alone are frequently not accurate enough to evaluate diseases such as appe...
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Computed tomography (CT) has become a critical tool in the diagnostic algorithm for acute appendicitis. For the clinician, history and physical examination alone are frequently not accurate enough to evaluate diseases such as appendicitis, where emergent decisions must be made about patient treatment. Compared with clinical assessment alone, CT increases the sensitivity, specificity, and accuracy of diagnosing acute appendicitis. Radiologists are constantly seeking ways to further optimize CT protocols and improve diagnostic accuracy. CT has dramatically decreased the morbidity, mortality, and healthcare costs associated with acute appendicitis, and will likely maintain its role as an important tool for diagnosing acute appendicitis in the forseeable future.
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Purpose: Our aim was to determine predictive factors for the diagnosis and postoperative complications of acute appendicitis. Materials and patients: Data sets of 1,439 consecutive adults and children who had an appendectomy betwe...
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Purpose: Our aim was to determine predictive factors for the diagnosis and postoperative complications of acute appendicitis. Materials and patients: Data sets of 1,439 consecutive adults and children who had an appendectomy between 1999 and 2008 were retrospectively analyzed. Results: A mild acute appendicitis was present in 50 % (n = 722) and a severe acute appendicitis in 25 % (n = 355) of the patients. No signs of any pathology were found in 6 % (n = 82). Gender, white blood count (WBC), C-reactive protein (CRP), and ultrasound (US) examination were important indicators of mild acute and severe acute appendicitis in adults and children. Postoperative complications occurred in 16 % (237/1,439), mainly consisting of wound infections (8 %, n = 122) and bowel dysfunction (5 %, n = 76). Sixty-two patients (4.3 %) required reoperations. One patient died (1/1,439, 0.07 % mortality rate). Age, pathology, and the presence of bacteria in the intraoperative swab were important predictive factors for postoperative complications in adults and children. Time since onset of symptoms and type of operation were also associated with postoperative complications among adults. Complications developed in 21 and 9 % of the adults (155/754 and 10/125) who had open and laparoscopic surgery, respectively. Conclusions: Besides history and clinical examination, WBC, CRP, and US examination remain important factors for diagnosing acute appendicitis. Complications are related to the pathology, presence of bacteria, and type of operation. Early diagnosis within 48 h may be important. A laparoscopic procedure in adults may also cause fewer wound infections.
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The purpose of this study was to assess our results of using graded compression ultrasonography (US) to confirm the diagnosis of acute appendicitis. Graded compression US was performed on 94 patients who presented at the Lehigh Va...
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The purpose of this study was to assess our results of using graded compression ultrasonography (US) to confirm the diagnosis of acute appendicitis. Graded compression US was performed on 94 patients who presented at the Lehigh Valley Hospital, Allentown, Pennsylvania with an equivocal clinical picture of acute appendicitis. When used to diagnose acute appendicitis, US provide a specificity of 93.7/100, sensitivity of 74.2/100, an accuracy of 87.2/100. We conclude that graded compression US was useful to rule out the diagnosis of acute appendicitis and helped to avoid unnecessary appendectomies and reduced negative laparotomies. Our results proved to be comparable to previously reported studies.
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Background: Elevated levels of circulating plasma and urine leucine-rich-2-glycoprotein-1 (LRG1) protein has been found in patients with acute appendicitis (AA) and may be useful for diagnosis. This study aimed to investigate whet...
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Background: Elevated levels of circulating plasma and urine leucine-rich-2-glycoprotein-1 (LRG1) protein has been found in patients with acute appendicitis (AA) and may be useful for diagnosis. This study aimed to investigate whether combined tests including circulating LRG1 mRNA levels improve the early diagnosis of AA.
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In recent years, digital endoscopy has established as key technology for medical screenings and minimally invasive surgery. Endoscopy image processing techniques have been applied to the diagnosis of diseases. In this paper, an ef...
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In recent years, digital endoscopy has established as key technology for medical screenings and minimally invasive surgery. Endoscopy image processing techniques have been applied to the diagnosis of diseases. In this paper, an effective approach is proposed to process endoscopic images to detect acute appendicitis. For this purpose, we first introduced image enhancement techniques that allow us to improve quality of endoscopic image for further processing. A simple and effective image segmentation technique was developed to detect vessels and vermiform appendix. The hierarchical set of features have been extracted for detecting acute appendicitis. It includes geometrical, colorimetric, densitometric, and topological features. For each appendicitis feature discriminant indexes have been introduced for diagnosis. This method has achieved good results in clinical application.
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Abstract Background Acute appendicitis (AA) is the most frequently seen surgical emergency in pregnant women and the most frequently encountered cause of non‐obstetric acute abdomen. Due to the physiological and anatomical change...
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Abstract Background Acute appendicitis (AA) is the most frequently seen surgical emergency in pregnant women and the most frequently encountered cause of non‐obstetric acute abdomen. Due to the physiological and anatomical changes that occur during pregnancy and the limited use of radiological methods, it is difficult to diagnose AA during pregnancy. These conditions increase the risk of morbidity and mortality; therefore, it is crucial to identify ideal laboratory markers that can be utilized to diagnose disease. Methods One hundred and ten pregnancies that fulfilled the inclusion criteria for AA diagnosis were retrospectively analysed between 2010 and 2021. Markers with high diagnostic values were discussed. Results The patients were divided into three groups as follows; Group I: negative appendectomy (n?=?19); Group IIa: uncomplicated appendicitis (n?=?59); Group IIb: complicated appendicitis (n?=?32). There was no statistically significant difference in mean age or gestational week (P?>?0.05). Group IIb had a higher rate of complications and a longer length of hospital stay (P?收起
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