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Selected Publication:
Zahiri, Q.
Development of diagnosis and management of patients with simple appendicitis at the Department of Pediatric and Adolescent Surgery in Graz in the period 1999 - 2008.
Humanmedizin; [ Diplomarbeit ] Medical University of Graz; 2014. pp. 79
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- Authors Med Uni Graz:
- Advisor:
- Haxhija Emir
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- Abstract:
- Abstract Appendicitis is the most common cause of acute abdomen in childhood. An appendectomy due to a concomitant appendicitis or due to a non-inflamed appendix is generally regarded as a false intervention. Therefore numerous studies attempted to find ways to reduce the number of unnecessary appendectomies. This study investigated the influence of the development of the diagnostic approach of patients with suspected appendicitis on their treatment over a 10-years period. Materials and Methods: We performed a retrospective examination of the entire patient population of the University Clinic for Pediatric and Adolescent Surgery Graz from the period 01.01.1999 - 31.12.2008. We included all patients who were admitted to the hospital with suspicion of appendicitis and either underwent a surgery for simple (acute and subacute) appendicitis or where discharged later from hospital without surgery. The following parameters were collected: Gender distribution, age distribution, duration of hospital stay, number of due to a simple appendicitis (subacute, acute) or non-inflamed appendix surgically treated patients on the basis of the discharge diagnoses (total / per year), histological diagnoses of the removed appendices and comparison of these to the discharge diagnoses. Other parameters included the total number of patients admitted for observation but discharged without surgery (total / per year), performance of abdomen ultrasonography with focused appendiceal search (yes / no), sonographically depicted appendix (yes / no), appendiceal diameter in mm at successful sonographic depiction, and leukocyte count and CRP values at the time of hospital admission. viii Results: 5458 patients were hospitalized during the 10-years period for suspected appendicitis. Out of these 2147 (39%) underwent an appendectomy, and 4745 (87%) were examined by abdominal ultrasonography, with clear depiction of appendix in 2402 patients (54%). We found that the higher the number of patients receiving abdominal ultrasound examinations and the higher the appendix depiction rate in ultrasound, the lower the number of patients admitted to the hospital due to suspected appendicitis and the lower the number of patients receiving surgery due to simple appendicitis. . Conclusion: The results of this study showed a significant decrease in the number of both, patients hospitalized because of appendicitis and those who had undergone surgery due to simple appendicitis during the 10-years study period. This decrease in the number of hospitalized patients and the number of surgically treated patients seems to be due to the increased number of diagnostic abdominal ultrasound examinations and the improvement of appendiceal identification rate in the ultrasound. The results of our study support the routine application of this imaging modality in the pre-operative evaluation of patients with suspected appendicitis.