Plasma total bilirubin levels in children with appendicitis admitted to the emergency department

Appendicitis is one of the most common reasons for emergency abdominal surgery in children. Appendicitis patients have complaints that are common with many conditions and diseases. Therefore, early and accurate diagnosis of acute appendicitis is important in avoiding morbidity and associated complications. The aim of this study was to investigate the importance of hyperbilirubinemia in both the diagnosis of acute appendicitis and in distinguishing the severity of appendicitis in children. This retrospective study included 242 patients, 118 of whom had surgery for appendicitis and 124 who were admitted with suspected appendicitis between January 2011 and February 2015. Age, gender, preoperative plasma total bilirubin levels and pathological examination reports from patients files were recorded. Patients with appendicitis were labelled as Group I. Patients with non-perforated appendicitis were in Group IA and patients with perforated appendicitis were in Group IB. Group II consisted of 124 patients who were hospitalized with suspected appendicitis but were discharged without an appendectomy. A statistically significant difference was observed between the two groups in terms of mean plasma total bilirubin levels (between group comparisons for Groups I and II, p = 0.007). According to the comparison of the subgroups with respect to the mean plasma total bilirubin levels, a statistically significant difference was not observed between subgroups IA and IB (p = 0.770). The present study indicates that plasma total bilirubin levels are not a reliable marker in either the diagnosis of appendicitis or the differentiation of perforated appendicitis from non-perforated appendicitis in children. [Med-Science 2017; 6(3.000): 483-5

Plasma total bilirubin levels in children with appendicitis admitted to the emergency department

Appendicitis is one of the most common reasons for emergency abdominal surgery in children. Appendicitis patients have complaints that are common with many conditions and diseases. Therefore, early and accurate diagnosis of acute appendicitis is important in avoiding morbidity and associated complications. The aim of this study was to investigate the importance of hyperbilirubinemia in both the diagnosis of acute appendicitis and in distinguishing the severity of appendicitis in children. This retrospective study included 242 patients, 118 of whom had surgery for appendicitis and 124 who were admitted with suspected appendicitis between January 2011 and February 2015. Age, gender, preoperative plasma total bilirubin levels and pathological examination reports from patients’ files were recorded. Patients with appendicitis were labelled as Group I. Patients with non-perforated appendicitis were in Group IA and patients with perforated appendicitis were in Group IB. Group II consisted of 124 patients who were hospitalized with suspected appendicitis but were discharged without an appendectomy. A statistically significant difference was observed between the two groups in terms of mean plasma total bilirubin levels (between group comparisons for Groups I and II, p = 0.007). According to the comparison of the subgroups with respect to the mean plasma total bilirubin levels, a statistically significant difference was not observed between subgroups IA and IB (p = 0.770).The present study indicates that plasma total bilirubin levels are not a reliable marker in either the diagnosis of appendicitis or the differentiation of perforated appendicitis from non-perforated appendicitis in childrenAppendicitis is one of the most common reasons for emergency abdominal surgery in children. Appendicitis patients have complaints that are common with many conditions and diseases. Therefore, early and accurate diagnosis of acute appendicitis is important in avoiding morbidity and associated complications. The aim of this study was to investigate the importance of hyperbilirubinemia in both the diagnosis of acute appendicitis and in distinguishing the severity of appendicitis in children. This retrospective study included 242 patients, 118 of whom had surgery for appendicitis and 124 who were admitted with suspected appendicitis between January 2011 and February 2015. Age, gender, preoperative plasma total bilirubin levels and pathological examination reports from patients’ files were recorded. Patients with appendicitis were labelled as Group I. Patients with non-perforated appendicitis were in Group IA and patients with perforated appendicitis were in Group IB. Group II consisted of 124 patients who were hospitalized with suspected appendicitis but were discharged without an appendectomy. A statistically significant difference was observed between the two groups in terms of mean plasma total bilirubin levels (between group comparisons for Groups I and II, p = 0.007). According to the comparison of the subgroups with respect to the mean plasma total bilirubin levels, a statistically significant difference was not observed between subgroups IA and IB (p = 0.770).The present study indicates that plasma total bilirubin levels are not a reliable marker in either the diagnosis of appendicitis or the differentiation of perforated appendicitis from non-perforated appendicitis in childre

Indication and efficacy of splenectomy in children with hematological disease

WOS: 000437950000007Purpose:. We aimed to research benefits and indications of splenectomy operation due to hematological disease in children. Materials and Methods: The children who underwent to splenectomy due to hematological diseases between 2009-2015 were included in this study. Age of patients, sex, diagnosis, post splenectomy infection, portal vein thrombosis (PVT), operation types, pre and post operative thrombocyte, leucocyte and hematocrit counts, simultaneous cholecystectomy, spleen size, the efficacy of operation were noted retrospectively. Results: Median age of the patients (n=58) was 8. 41% of them were girl and 51% were boy. PVT occurred in 4 patients after splenectomy. 8 of them underwent splenectomy laparoscopically. 2 had conversion due to uncontrolled bleeding. 14 patients underwent cholecystectomy simultaneously. Diagnosis were sickle cell anemia (SCA) (n=20, 34.5%), thalassemia major (n=17, 29.3%) and immune thrombocytopenic purpura (ITP) (n=6, 10.3%). 9 (15%) patients were hospitalized because of post splenectomy infections. Efficacy of splenectomy was not evaluated in 17 patients due to data lack. Efficacy of splenectomy was 85% in evaluated patients. 4 patients were death. One each of thalassemia major and ITP patients had no benefit and all of SCA patients had benefited from splenectomy. Conclusion: Splenectomy is still efficient operation procedure for many hematologic diseases. Age of patients is also important in respect of increasing thrombocyte count

Drainage Systems' Effect on Surgical Site Infection in Children with Perforated Appendicitis

WOS: 000410618200003Aim: Effect of replacing open drainage system to closed drainage system on surgical site infection (551) in children operated for perforated appendicitis was evaluated. Material and Method: Hospital files and computer records of perforated appendicitis cases operated in 2004-2010 were evaluated retrospectively. Open drainage systems were used for 70 in cases (group I) and closed systems were used in the others (group II). Results: Eleven of 551 cases had superficial infection and 3 had the organ/space infection. 551 rate was 15.795 for group I and 7.59'n for the group II. The antibiotic treatment length was 7.5 t 3.4 days for group I and 6.4 2.2 days for group II and the difference between groups was not statistically significant. Hospitalization length for group I was 8.2 3.1 days and 6.8 1.9 days for group II and the difference was statistically significant. Discussion: 551 is an important problem increasing morbidity and treatment costs through increasing hospitalization and antibiotic treatment length. Open drainage system used in operation in patients with perforated appendicitis leads an increased frequency of SSI when compared to the closed drainage system. Thus, closed drainage systems should be preferred in when drainage is necessary in operations for perforated appendicitis in children

Determining the Risk Factors for Anastomotic Stricture Development after Esophageal Atresia Repair: Results from the Turkish Esophageal Atresia Registry

Introduction Anastomotic stricture (AS) is the second most common complication after esophageal atresia (EA) repair. We aimed to evaluate the data in the Turkish Esophageal Atresia Registry to determine the risk factors for AS development after EA repair in a large national cohort of patients. Methods The data between 2015 and 2021 were evaluated. Patients were enrolled into two groups according to the occurrence of AS. Patients with AS (AS group) and without AS (non-AS group) were compared according to demographic and operative features, postoperative intubation status, and postoperative complications, such as anastomotic leaks, fistula recanalization, and the presence of gastroesophageal reflux (GER). A multivariable logistic regression analysis was performed to define the risk factors for the development of AS after EA repair. Results Among the 713 cases, 144 patients (20.19%) were enrolled into the AS group and 569 (79.81%) in the non-AS group. The multivariable logistic regression showed that, being a term baby (odds ratio [OR]: 1.706; p = 0.006), having a birth weight over 2,500 g (OR: 1.72; p = 0.006), presence of GER (OR: 5.267; p 0.001), or having a recurrent tracheoesophageal fistula (TEF, OR: 4.363; p = 0.006) were the risk factors for the development of AS. Conclusions The results of our national registry demonstrate that 20% of EA patients developed AS within their first year of life. In patients with early primary anastomosis, birth weight greater than 2,500 g and presence of GER were risk factors for developing AS. When patients with delayed anastomosis were included, in addition to the previous risk factors, being a term baby, and having recurrent TEF also became risk factors