Problemi correnti
L’appendicite acuta oggi
ACUTE APPENDICITIS
BRUNO CIGLIANO, NICOLAOS BALTOGIANNIS, ALESSANDRO SETTIMI
Chirurgia Pediatrica, Dipartimento di Pediatria, Università “Federico II” di Napoli
Febbraio 2003 - pagg. 99 -102
Abstract
Acute appendicitis is caused by the obstruction of the lumen due to coprolytes, mucus,
lymphoid hyperplasia. The earliest symptom is periumbilical pain accompanied by vomiting.
Later the appendix gets infected, fever develops and the peritoneum gets involved. The pain
becomes more localised. Diagnosis can be improved by clinical monitoring and imaging. The
Alvarado score helps identifying children who should undergo ultrasound. Diagnostic sensitivity
of ultrasound is very close to 100% with a specificity of 90%. Spiral CT scan reduces by
50% the number of unnecessary appendicectomies. 86% of patients can be discharged within
24 hours from surgery.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
1. Behrman RE, Kliegman RM, Arvin AM.
Nelson Textbook of Pediatrics. Cap.289, pag.
1109. WB Saunders, 1996.
2. Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med 1986;15:557-64.
3. Davidson PM, Douglas CD, Hosking CS. Graded compression ultrasonography in the assessment of the “tough decision” acute abdomen in childhood. Pediatr Surg Int 1999;15: 32-5.
4. Garcia Peña BM, Taylor GA, Lund DP, et al. Effect of computed tomography on patient management and costs in children with suspected appendicitis. Pediatrics 1999;104,3:440-6.
5. Turan C, Tutus A, Ozokutan BH, et al. The evaluation of Technetium 99m-Citrate scintigraphy in chidren with suspected appendicitis. J Ped Surg 1999;34,8:1272-5.
6. Banani SA, Talei A. Can oral metronidazole substitute parenteral drug therapy in acute appendicitis? A new policy in the management of simple or complicated appendicitis with localized peritonitis: a randomized controlled clinical trial. Am Surg 1999;65,5:411-6.
7. Andersson R, Lambe M, Bergstrom R. Fertility patterns after appendicectomy: historical cohort study. BMJ 1999;10,318:963-7.
1109. WB Saunders, 1996.
2. Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med 1986;15:557-64.
3. Davidson PM, Douglas CD, Hosking CS. Graded compression ultrasonography in the assessment of the “tough decision” acute abdomen in childhood. Pediatr Surg Int 1999;15: 32-5.
4. Garcia Peña BM, Taylor GA, Lund DP, et al. Effect of computed tomography on patient management and costs in children with suspected appendicitis. Pediatrics 1999;104,3:440-6.
5. Turan C, Tutus A, Ozokutan BH, et al. The evaluation of Technetium 99m-Citrate scintigraphy in chidren with suspected appendicitis. J Ped Surg 1999;34,8:1272-5.
6. Banani SA, Talei A. Can oral metronidazole substitute parenteral drug therapy in acute appendicitis? A new policy in the management of simple or complicated appendicitis with localized peritonitis: a randomized controlled clinical trial. Am Surg 1999;65,5:411-6.
7. Andersson R, Lambe M, Bergstrom R. Fertility patterns after appendicectomy: historical cohort study. BMJ 1999;10,318:963-7.