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Management Strategies of Appendix with Mild Inflammation

Year 2014, , 120 - 123, 01.05.2014

Adnan Haşlak Zeynep Şener Bahçe Ramazan Büyükkaya Beyza Özçınar

https://doi.org/10.5505/abantmedj.2014.50470

Abstract

OBJECTIVE: In this study, we examined the cases with mild acute appendicitis and their treatments with different modalities and their follow up. METHODS: 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 balance. First group was appendectomy group, second was antibiotic 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 ultrasonography 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 treatment and one patient after 2 days of treatment and were subsequently operated in the second admission. However, no chronic findings were noted at histopathological examination. CONCLUSION: Most of the early acute appendicitis, there is no need for appendectomy.

Keywords

Acute appendicitis mild inflammation antibiotics follow up conservative management

References

  • 1. Mosegaard A, Nielsen OS. Interval appendectomy: A retrospective study. Acta Chir Scand 1979;145:109–111.
  • 2. Adams ML. The medical management of acute appendicitis in a non-surgical environment: a retrospective case review. Mil Med 1990;155:345–347.
  • 3. Butler C. Surgical pathology of acute appendicitis. 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 operative interference in cases of disease of the vermiform 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 appendicitis and the appendix mass Br J Surg. 1945;32:365–370.
  • 8. Coldrey E. Five years of conservative treatment 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 management 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 appendicectomy as primary treatment of acute appendicitis in unselected patients. Br J Surg 2009; 96: 473– 481.
  • 12. Styrud J, Eriksson S, Nilsson I et al. Appendectomy versus antibiotic treatment in acute appendicitis. a prospective multicenter randomized controlled trial. World J Surg 2006; 30: 1033–1037.
  • 13. Bagi P, Dueholm S, Karstrup S. Percutaneous drainage of appendiceal abscess. An alternative to conventional treatment. Dis Colon Rectum 1987; 30: 532–535.
  • 14. Adams ML. The medical management of acute appendicitis in a nonsurgical environment: a retrospective case review. Mil Med 1990; 155: 345–347.
  • 15. Butsch DW, Jothi R, Butsch WL, Butsch JL. Recurrent appendicitis: Fact not fallacy. Postgrad 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 inflammation in acute appendicitis: A comparison with clinical findings. Acta Chir Scand 1989;155:185- 189.
  • 18. Heler MB, Skolnick ML. Ulrasound documentation of spontenously resolving appendicitis. 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. Spontenously 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 appendicitis: a clinical study of 1018 cases of emergency appendectomy. Acta Chir Scand 1982;148:51–62.

Hafif inflamasyonlu apendisitte tedavi yaklaşımları

Year 2014, , 120 - 123, 01.05.2014

Adnan Haşlak Zeynep Şener Bahçe Ramazan Büyükkaya Beyza Özçınar

https://doi.org/10.5505/abantmedj.2014.50470

Abstract

AMAÇ: Akut apandisit tedavisi halen klinik bir tartışmadır. Bu çalışmada, erken akut apandisit tanısı alan hastalarda değişik tedavi yaklaşımlarını ve bunların takiplerini tartışmayı amaçladık.YÖNTEMLER: Ağustos 2008 ve Ocak 2010 tarihleri arasında erken dönem akut apandisit tanısı konulan 45 hasta çalışmaya 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 arasında yaş, cinsiyet, beyaz küre sayısı ve ultrasonografi sonuçları 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 raporlarında kronik apandisit bulgusu saptanmadı.SONUÇ: Apendektomi erken akut apandisit düşünülen hastaların çoğunda gerekli değildir.

Keywords

Akut apandisit hafif inflamasyon antibiyotikler takip konservatif tedavi

References

  • 1. Mosegaard A, Nielsen OS. Interval appendectomy: A retrospective study. Acta Chir Scand 1979;145:109–111.
  • 2. Adams ML. The medical management of acute appendicitis in a non-surgical environment: a retrospective case review. Mil Med 1990;155:345–347.
  • 3. Butler C. Surgical pathology of acute appendicitis. 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 operative interference in cases of disease of the vermiform 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 appendicitis and the appendix mass Br J Surg. 1945;32:365–370.
  • 8. Coldrey E. Five years of conservative treatment 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 management 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 appendicectomy as primary treatment of acute appendicitis in unselected patients. Br J Surg 2009; 96: 473– 481.
  • 12. Styrud J, Eriksson S, Nilsson I et al. Appendectomy versus antibiotic treatment in acute appendicitis. a prospective multicenter randomized controlled trial. World J Surg 2006; 30: 1033–1037.
  • 13. Bagi P, Dueholm S, Karstrup S. Percutaneous drainage of appendiceal abscess. An alternative to conventional treatment. Dis Colon Rectum 1987; 30: 532–535.
  • 14. Adams ML. The medical management of acute appendicitis in a nonsurgical environment: a retrospective case review. Mil Med 1990; 155: 345–347.
  • 15. Butsch DW, Jothi R, Butsch WL, Butsch JL. Recurrent appendicitis: Fact not fallacy. Postgrad 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 inflammation in acute appendicitis: A comparison with clinical findings. Acta Chir Scand 1989;155:185- 189.
  • 18. Heler MB, Skolnick ML. Ulrasound documentation of spontenously resolving appendicitis. 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. Spontenously 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 appendicitis: a clinical study of 1018 cases of emergency appendectomy. Acta Chir Scand 1982;148:51–62.
There are 23 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

Adnan Haşlak This is me

Zeynep Şener Bahçe This is me

Ramazan Büyükkaya This is me

Beyza Özçınar This is me

Publication Date May 1, 2014
Published in Issue Year 2014

Cite

APA Haşlak, A., Bahçe, Z. Ş., Büyükkaya, R., Özçınar, B. (2014). Management Strategies of Appendix with Mild Inflammation. Abant Medical Journal, 3(2), 120-123. https://doi.org/10.5505/abantmedj.2014.50470
AMA Haşlak A, Bahçe ZŞ, Büyükkaya R, Özçınar B. Management Strategies of Appendix with Mild Inflammation. Abant Med J. May 2014;3(2):120-123. doi:10.5505/abantmedj.2014.50470
Chicago Haşlak, Adnan, Zeynep Şener Bahçe, Ramazan Büyükkaya, and Beyza Özçınar. “Management Strategies of Appendix With Mild Inflammation”. Abant Medical Journal 3, no. 2 (May 2014): 120-23. https://doi.org/10.5505/abantmedj.2014.50470.
EndNote Haşlak A, Bahçe ZŞ, Büyükkaya R, Özçınar B (May 1, 2014) Management Strategies of Appendix with Mild Inflammation. Abant Medical Journal 3 2 120–123.
IEEE A. Haşlak, Z. Ş. Bahçe, R. Büyükkaya, and B. Özçınar, “Management Strategies of Appendix with Mild Inflammation”, Abant Med J, vol. 3, no. 2, pp. 120–123, 2014, doi: 10.5505/abantmedj.2014.50470.
ISNAD Haşlak, Adnan et al. “Management Strategies of Appendix With Mild Inflammation”. Abant Medical Journal 3/2 (May 2014), 120-123. https://doi.org/10.5505/abantmedj.2014.50470.
JAMA Haşlak A, Bahçe ZŞ, Büyükkaya R, Özçınar B. Management Strategies of Appendix with Mild Inflammation. Abant Med J. 2014;3:120–123.
MLA Haşlak, Adnan et al. “Management Strategies of Appendix With Mild Inflammation”. Abant Medical Journal, vol. 3, no. 2, 2014, pp. 120-3, doi:10.5505/abantmedj.2014.50470.
Vancouver Haşlak A, Bahçe ZŞ, Büyükkaya R, Özçınar B. Management Strategies of Appendix with Mild Inflammation. Abant Med J. 2014;3(2):120-3.