Document Detail


An assessment of the severity of recurrent appendicitis.
MedLine Citation:
PMID:  14672785     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study examines the clinical characteristics of patients who developed recurrent appendicitis after previous nonoperative management of perforated appendicitis. METHODS: Retrospective chart review was performed, and data from the recurrent and initial episode of appendicitis were collected. RESULTS: In all, 237 patients from 1989 to 2001 were managed nonoperatively for perforated appendicitis and 32 (14%) were readmitted for recurrent appendicitis. Median white blood cell count at recurrence was 9.5 (interquartile range [IQR]: 6.6 to 13.2] versus 13.1 [IQR: 10.8 to 16.1] at initial presentation (P = 0.002). Maximum temperature was 98.6 degrees F [IQR: 98.2 to 100.5] at recurrence versus 100.3 degrees F [IQR: 99.5 to 101.5] (P = 0.008). Median time for intravenous antibiotics use was 3 [IQR: 3 to 7] days at recurrence versus 6 [IQR: 4 to 8] days initially (P = 0.01). Inpatient stay was also shorter; median length was 6 [IQR: 3 to 8] days compared with 7 [IQR: 5 to 9] days at initial presentation (P = 0.02). CONCLUSIONS: Patients managed nonoperatively for perforated appendicitis who later developed recurrent appendicitis exhibited a milder clinical course at recurrence. Elective interval appendectomy may be reserved until a recurrent episode.
Authors:
Matthew R Dixon; Jason S Haukoos; Ina U Park; David Oliak; Ravin R Kumar; Tracey D Arnell; Michael J Stamos
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  186     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-15     Completed Date:  2004-01-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  718-22; discussion 722     Citation Subset:  AIM; IM    
Affiliation:
Division of Colon and Rectal Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Bacterial Agents / administration & dosage
Appendectomy
Appendicitis / diagnosis*,  therapy
Female
Humans
Infusions, Intravenous
Male
Middle Aged
Recurrence
Retrospective Studies
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

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