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At least 775 records · Page 43Linked to original sources
PubMed1987

Reiter's syndrome and recurrent peritonitis after appendectomy.

A 15-year-old male adolescent underwent an appendectomy for acute gangrenous appendicitis. One week after surgery, he underwent an exploratory laparotomy that revealed two pericecal abscesses, which were drained. Two weeks later, he had diffuse peritonitis and underwent another laparotomy, which revealed a sterile fibrinous peritonitis. Oligoarticular inflammatory arthritis, urethritis, and recurrent peritonitis subsequently developed. He was found to be positive for HLA-B27 antigens. This case report illustrates that reactive arthritis (Reiter's syndrome) may develop after peritoneal infections. It also raises the possibility that the inflammatory process, which involves other serosal surfaces in Reiter's syndrome, may affect the peritoneum.

Abscess↗
PubMed1986

The effect of tonsillectomy and appendectomy on the development of rheumatoid arthritis.

The possibility of an association between rheumatoid arthritis (RA) and prior tonsillectomy and appendectomy was investigated in a community based case-control study of 229 female cases of probable and definite RA and 458 appropriately matched controls. No association was found with logistic analysis even when controlling for a variety of factors such as socio-economic status, oral contraceptive use, and their interactions.

Appendectomy↗
PubMed1987

Fatal acute dissection of the right hepatic artery after appendectomy.

A 53-year-old normotensive man underwent an appendectomy for suppurative appendicitis with peritonitis and Escherichia coli bacteremia. On the third postoperative day, he became severely dyspneic, developed bright red blood flow from his abdominal drains, collapsed, and died. At autopsy, a ruptured intramedial dissection of the right hepatic artery was found. Hepatic artery dissections are rare, but may be associated with abdominal operation, peritonitis, hypertension, or preexisting arterial disease.

Aortic Dissection↗
PubMed1979

Appendectomies during physicians' boycott. Analysis of surgical care.

The 1975 San Francisco physicians' boycott caused major changes in patterns of providing surgical care, but there was no appreciable change in the number of appendectomies performed during the boycott month when compared with a six-month baseline period. The ratio of normal to inflamed appendices removed was no different during the boycott than it was during the control period, and no differences were noted in the percentage of cases perforating in the boycott month when compared with the control period. In addition, patients seeking care for appendicitis during the boycott month did not experience delays. The lack of change in the standard direct and indirect indicators used to monitor quality of care suggests no major lapses in appendicitis care occurred in San Francisco during the boycott.

Adolescent↗
PubMed1983

Prophylactic metronidazole in appendectomy: a double-blind controlled trial.

Ninety-eight patients with suspected nonperforated acute appendicitis have to date been entered into a continuing, prospective, blinded randomized trial to determine the role of prophylactic metronidazole in postoperative wound infection. Twenty-six patients were excluded for the following reasons: diagnosis other than acute appendicitis (16), perforation of the appendix (8), administration of other antibiotics (1), and refusal to enter study (1). Seventy-two patients, 47 men and 25 women, with a mean age of 27.5 years (range 15 to 60 years), underwent appendectomy and were studied. Thirty patients received 1 gm intravenous metronidazole preoperatively and five intravenous doses of 500 mg metronidazole postoperatively. Forty-two patients received placebo only. Cultures of the appendiceal stump grew aerobic cultures in 45 (62%) and anaerobic organisms in 29 (40%): Escherichia coli and Bacteroides fragilis, respectively. Six of the 72 patients (8.2%) developed postoperative wound infections: four of 42 (9.5%) who received placebo and two of 30 (6.6%) who received metronidazole (P = 0.54 by Fisher exact test). No toxicity from metronidazole was observed. The postoperative wound infection rate is insufficient to demonstrate the efficacy of metronidazole for prophylaxis in nonperforated acute appendicitis, although there appears to be a tendency of to assume its efficacy in this regard.

Adolescent↗
PubMed1983

The role of prophylactic antibiotics in appendectomy using delayed primary closure.

A prospective randomized trial of prophylactic antibiotics in 202 patients undergoing appendectomy is reported upon. The antibiotics used were metronidazole and cephradine. Half of the patients received antibiotics preoperatively. The other half received antibiotics at operation only upon finding perforation, gangrene or pus formation. All wounds were treated by delayed primary closure. No instance of wound infection, defined as abscess formation or cellulitis, occurred in either group. Antibiotics given prophylactically in every instance appear to have no advantage in preventing wound infection when delayed primary closure is used.

Adolescent↗
PubMed1978

[Diagnosis and treatment of intraperitoneal abscesses after appendectomy].

The symptoms and complex treatment method of the post-appendectomy abscesses in destructive appendicitis are set forth in this work. The author believes that there is a number of characteristic signs helping to recognize these complications in due time within the postoperative period. An expedient surgical intervention and intense therapy have permitted to gain quite favorable results in the treatment of such severe cases.

Abscess↗
PubMed1983

A controlled study of single dosage cefamandole in the prophylaxis of wound infections in appendectomy.

A series of 102 consecutive patients undergoing appendectomy through an incision in the right iliac fossa entered a prospective randomized trial to compare the effects of a 2 gram intravenous bolus dose of cefamandole with a control study. No differences occurred in the incidence of wound infection in the two groups. We conclude that there is no place for a single preoperative dosage of cefamandole in the management of appendicitis.

Adult↗
PubMed1982

[Perioperative antibiotic prophylaxis with cefamandole before appendectomy. A prospective randomized double-blind study].

In a prospective randomized double blind study, prophylactic cefamandol therapy was compared to placebos before appendectomy. 25 of 220 patients had to be excluded. The overall infection rate was reduced from 13,1% (1977/78) to 7,6% (1979/80). The infection rate differed in both groups (antibiotic and placebo) only for perforated appendices significantly. If there was a wound infection, the hospital stay of the treatment group was significantly reduced to the placebo group (p less than 0,0005). Predisposing factors for wound infection are leucocytosis greater than 12 000, anamnesis greater than 24 hours, operation time greater than 45 minutes.

Appendectomy↗
PubMed1978

[Is an appendectomy indicated when a diagnosis of acute appendicitis is not confirmed during the operation?].

In 236 out of 11,150 (1.8%) patients operated upon for acute appendicitis some other acute surgical and gynecological diseases were revealed. In this group of patients the vermiform process either seemed to be unchanged or its changes were considered to be secondary ones (reaction to an inflammation in adjacent organs). Histological study of vermiform processes proved the abscence of inflammatory alterations only in 35 cases. In the rest of patients either chronic or acute inflammatory process was found. The conclusion has been drawn that in case when diagnosis of acute appendicitis is not confirmed during operation, appendectomy does not produce any unfavourable effect upon the postoperative clinical course and outcome of the main disease and should be considered as a compulsory element of a surgical intervention.

Acute Disease↗
PubMed1981

[Prospective study on the prevention of wound infections after appendectomy for acute appendicitis].

In the search for an appropriate antibiotic to reduce the rate of postoperative wound infection in patients with acute appendicitis, we have randomized 150 patients preoperatively in a prospective 3-arm study. The operation technique was standardized for all patients and involved the use of plastic wound protectors. Bacterial contamination was documented by 3 swabs taken during operation. In 2 arms, patients received short-term adjuvant prophylaxis with either cefazolin or clindamycin/tobramycin. The third arm served as a control. Wound contamination ws proven in 33% of all cases but only 4% developed a real wound infection. The rate of infection was almost identical in all groups, without a statistically significant difference in the chi2 test. It is concluded that wound infection after appendectomy cannot be prevented by prophylactic use of antibiotics. Careful operation technique with local protective steps is quite sufficient. Antibiotics should therefore be reserved for special indications.

Acute Disease↗
PubMed1980

Incidental appendectomy: frequency of pathologic abnormalities.

The incidence of pathologic abnormalities found in the appendix when it is removed incidentally at the time of jejunoileal bypass is reported. Thirty-one per cent of these appendices had significant histopathologic changes. In the authors' opinion these findings support the theory that the appendix may undergo bouts of acute inflammation that are self-limited and that the fibrosis observed in the appendix is a direct sequela of such episodes. In potentially contaminated primary procedures the addition of incidental appendectomy does not increase operative morbidity or mortality.

Adolescent↗
PubMed1994

[Results of a prospective study of laparoscopic appendectomy].

Laparoscopic appendicectomy for acute appendicitis is being increasingly criticized, because of the possible complications, the technical effort required and the high costs. The results of the present prospective study performed between May 1992 and March 1994 on 222 appendectomies (110 conventional and 112 laparoscopic) are intended to serve as a tentative guide. The use of endoscopic stapling and cutting devices, as well as the observance of exclusion criteria make laparoscopic appendicectomy a safe operation. It can be employed routinely and shows certain advantages for the patient e.g. fewer disturbances of wound healing and shorter postoperative hospitalization. Although laparoscopic appendicectomy has brought us valuable experience, it is by no means the method of choice and for the time being, it is unlikely to replace conventional appendicectomy.

Adult↗
PubMed1995

Single-dose cefotetan or cefoxitin versus multiple-dose cefoxitin as prophylaxis in patients undergoing appendectomy for acute nonperforated appendicitis.

OBJECTIVE: A prospective, double-blind study was performed to examine the effects of prophylactic cefotetan and cefoxitin in postoperative wound infection for patients with nonperforated acute appendicitis. METHODS: One hundred thirty-six of 179 patients with a clinical diagnosis of appendicitis were evaluated and divided into three groups: group 1 received 2 g cefotetan preoperatively, group 2 received 2 g cefoxitin preoperatively, and group 3 received 2 g cefoxitin preoperatively followed by three postoperative doses. RESULTS: The overall wound infection rate was 4.6 percent. Group 2 (single-dose cefoxitin) had a significantly higher wound infection rate (11.1 percent) than group 1 (single-dose cefotetan) (zero percent) or group 3 (multiple-dose cefoxitin) (1.9 percent). CONCLUSIONS: Single-dose cefotetan and multiple-dose cefoxitin are equally effective. However, because of the greater convenience and markedly decreased cost, single-dose cefotetan is the prophylaxis of choice in appendectomy for nonperforated appendicitis.

Acute Disease↗
PubMed1994

[How to reduce the number of negative appendectomies? A prospective two-center study of 120 patients].

A decisional protocol based on clinical findings and laboratory data was assessed prospectively in a consecutive series of 120 patients with suspected appendicitis over a 24-month period at 2 teaching hospitals. Using this protocol the high rate of negative appendectomy (31.5%) during the 2 years prior to the study was reduced to 22% without increasing morbidity or mortality. Ultrasound examination was poorly predictive in unclear cases. Laparoscopy was used to assess diagnosis in persistent symptoms.

Adolescent↗
PubMed1994

[Laparoscopic appendectomy at the Department of Surgery in Jablonec nad Nisou].

The paper deals with experience regarding laparoscopic appendectomy at the Department of Surgery in Jablonec nad Nisou. Between May, 1992 and Jan. 1, 1994 the authors performed 82 operations. They are listed in a table according to pathological findings and the number of complications according to a described classification. In the author's opinion the advantage of the new method is, as compared with the classical open one, a shorter time of hospitalization and a substantially shorter period of convalescence.

Adolescent↗