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Update on the Diagnosis and Treatment of Appendicitis
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Update on the Diagnosis and Treatment of Appendicitis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 30 June 2024 | Viewed by 3202

Special Issue Editors

Prof. Dr. George Vaos

E-Mail Website
Guest Editor
Department of Pediatric Surgery, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
Interests: neonatal surgery; pediatric gastrointestinal surgery; pediatric thoracic surgery; pediatric urology
Prof. Dr. Nikolaos Zavras

E-Mail Website
Guest Editor
Department of Pediatric Surgery, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
Interests: pediatric laparoscopic surgery; bariatric surgery; oncology

Special Issue Information

Dear Colleagues,

Appendicitis is one of the most common abdominal surgical emergencies in adults and children in the world, with a lifetime risk of 8.6% in males and 6.7% in females. The diagnosis of appendicitis is always a challenge. Delays in presenting to the physician and further delays in proper treatment due to misdiagnosis can increase the possibility of complications, especially in children. Although diagnosis is primarily clinical, the utilization of imaging and different scores can stratify patients in low, moderate, or high-risk groups and help in making a timely diagnosis. In patients at moderate to high-risk, surgical consultation should be conducted promptly to reduce morbidity and mortality resulting from the perforation of the appendix. Some controversies over strategies for treating appendicitis have been generated without a complete consensus. Laparoscopic or open appendicectomy is the standard treatment of appendicitis. However, some patients with perforated appendicitis may benefit from immediate surgery or initial antibiotic treatment, followed by interval appendicectomy, and several studies have even suggested a non-operative treatment with antibiotics alone in selected cases. The purpose of this Special Issue is to provide an update on the critical debates regarding the above aspects of appendicitis, and to discuss recent controversies in the field. Original articles, systematic reviews, meta-analyses and short communications on the topics described above are welcome. We also invite relevant basic, translational and clinical research.

Prof. Dr. George Vaos
Prof. Dr. Nikolaos Zavras
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • appendicitis
  • complicated appendicitis
  • imaging in appendicitis
  • scoring in appendicitis
  • laparoscopic appendicectomy
  • open appendicectomy
  • conservative treatment of appendicitis
  • controversies in diagnosis
  • controversies in treatment

Published Papers (2 papers)

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12 pages, 1536 KiB  
Systematic Review
Utility of Ischemia-Modified Albumin as a Biomarker for Acute Appendicitis: A Systematic Review and Meta-Analysis
by Apoorv Singh, Zenon Pogorelić, Aniket Agrawal, Carlos Martin Llorente Muñoz, Deepika Kainth, Ajay Verma, Bibekanand Jindal, Sandeep Agarwala and Sachit Anand
J. Clin. Med. 2023, 12(17), 5486; https://doi.org/10.3390/jcm12175486 - 24 Aug 2023
Cited by 6 | Viewed by 1682
Abstract
Background: Acute appendicitis is a frequently encountered surgical emergency. Despite several scoring systems, the possibility of delayed diagnosis persists. In addition, a delayed diagnosis leads to an increased risk of complicated appendicitis. Hence, there is a need to identify biological markers to help [...] Read more.
Background: Acute appendicitis is a frequently encountered surgical emergency. Despite several scoring systems, the possibility of delayed diagnosis persists. In addition, a delayed diagnosis leads to an increased risk of complicated appendicitis. Hence, there is a need to identify biological markers to help clinicians rapidly and accurately diagnose and prognosticate acute appendicitis with a high sensitivity and specificity. Although several markers have been evaluated, the pressing concern is still the low specificity of these markers. One such marker is serum ischemia-modified albumin (IMA), which can be a novel biomarker for accurately diagnosing and prognosticating acute appendicitis. Methods: The authors conducted a systematic search of the PubMed, EMBASE, Web of Science, and Scopus databases through February 2023 as per the PRISMA guidelines. The difference in the levels of IMA between patients with acute appendicitis vs. healthy controls, and the difference in the levels of IMA between patients with complicated vs. non-complicated acute appendicitis were taken as the outcome measures. Statistical analysis was performed using a random effects model and mean difference (MD) was calculated. The methodological quality of the studies was assessed by utilizing the Newcastle–Ottawa scale. Results: A total of six prospective comparative studies were included in the meta-analysis. The analysis revealed that the mean level of serum IMA was significantly raised in the acute appendicitis group (MD 0.21, 95% CI 0.05 to 0.37, p = 0.01). Similarly, the mean serum IMA levels were also raised in the complicated appendicitis group compared to the non-complicated appendicitis group (MD 0.05, 95% CI 0.01 to 0.10, p = 0.02). Three of the studies included were, however, of poor methodological quality. Conclusions: Serum IMA is a viable potential marker for diagnosing and prognosticating acute appendicitis. However, due to the limited methodological quality of available studies, further prospectively designed and adequately powered studies are needed. Full article
(This article belongs to the Special Issue Update on the Diagnosis and Treatment of Appendicitis)
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14 pages, 568 KiB  
Systematic Review
The Impact of Obesity on Perioperative Outcomes for Children Undergoing Appendectomy for Acute Appendicitis: A Systematic Review
by Nikolaos Zavras, Natalia Vaou, Sofia Zouganeli, Arezina Kasti, Papakonstantinou Dimitrios and George Vaos
J. Clin. Med. 2023, 12(14), 4811; https://doi.org/10.3390/jcm12144811 - 21 Jul 2023
Viewed by 1022
Abstract
Today, the prevalence of obesity in the pediatric population has increased dramatically. Acute appendicitis (AA) is the most common surgical condition among pediatric patients. We aimed to investigate the impact of obesity on postoperative outcomes in terms of operative time (OT), length of [...] Read more.
Today, the prevalence of obesity in the pediatric population has increased dramatically. Acute appendicitis (AA) is the most common surgical condition among pediatric patients. We aimed to investigate the impact of obesity on postoperative outcomes in terms of operative time (OT), length of stay (LOS), surgical site infection (SSI), overall complications, adverse events, and mortality in children undergoing appendectomy for acute appendicitis. An extensive search of the literature in PubMed and Google Scholar was conducted to evaluate the outcomes of normal weight (NW), overweight (OW), and obese (OB) children who underwent appendectomy. Although no statistically significant differences were noted in perioperative outcomes and overall postoperative complications between OW/OB and NW children in the majority of the included studies, prolonged OT and LOS and SSI were found in some studies. Moreover, no differences in terms of readmissions and ED visits were recorded. We conclude that the impact of obesity on postoperative outcomes for children undergoing appendectomy for AA is unclear, and, therefore, no safe conclusions can be drawn with the currently available data. Due to the lack of high-quality studies, further research is required to optimize the surgical approach and prevent unwarranted complications. Full article
(This article belongs to the Special Issue Update on the Diagnosis and Treatment of Appendicitis)
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