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...Complications and their Treatment Following appendectomy, recount signs of intra-abdominal abscess, and order a CT scan to confirm the diagnosis.
If the patient has a fever, persistent leukocytosis, prolonged ileus, and continued pain, an abscess should be suspected.
These signs and...
Last Updated March 17, 2023
FIGURE
Surgery: Basic Science and Clinical Evidence, 2e > Chapter 13. Intraabdominal Infections
FIGURE
The SAGES Manual: Volume 1, Basic Laparoscopy and Endoscopy, 3e > Chapter 14. Laparoscopy During Pregnancy
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The SAGES Manual: Volume 1, Basic Laparoscopy and Endoscopy, 3e > Chapter 14. Laparoscopy During Pregnancy
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The SAGES Manual: Volume 1, Basic Laparoscopy and Endoscopy, 3e > Chapter 14. Laparoscopy During Pregnancy
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Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice, 21e > 51. The Appendix
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Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice, 21e > Chapter 72. Surgery in the Pregnant Patient
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Surgical Pitfalls: Prevention and Management > Chapter 6. General Laparotomy
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Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice, 21e > 51. The Appendix
Videos
7 minutes, 48 seconds,
Videos
18 minutes, 33 seconds
Videos
17 minutes, 37 seconds,
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... timing of operation in a patient with acute appendicitis? Is antibiotic therapy alone an acceptable approach in acute appendicitis? What is an appropriate negative appendectomy rate? How do you approach the complicated appendix with a phlegmon that is difficult to distinguish from the cecum and...
Last Updated August 17, 2023
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... initially with antibiotics and delay the operation. If it is an abscess, you should drain percutaneously and assess the need for interval appendectomy....
Last Updated January 1, 0001
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...Assessment of Outcomes Be able to discuss the relative merits of a laparoscopic versus open approach to appendectomy.
In the mid to late 1990s, about 20% of appendectomies were performed via an open approach. Today, more than 90% are performed laparoscopically.
Contemporary meta-analyses...
Last Updated March 28, 2023
Videos
00 hour, 02 minutes, 25 seconds,
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...A 45-year-old male presents to your office 2 weeks status post laparoscopic appendectomy for acute appendicitis. Pathology reveals a 0.8-cm focus of carcinoid tumor. What is your management of this patient? Understand the follow-up needed for patients with benign carcinoid tumors....
Last Updated August 15, 2023
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...A 9-year-old girl underwent open appendectomy at an outside hospital 8 days ago. She had a normal appendix on the final pathology report but still has persistent lower abdominal pain and distention. Discuss the possible causes. An ovarian cause of the symptoms (cyst, neoplasm, torsion) may be the...
Last Updated January 1, 0001
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...A 28-year-old man presents to the emergency department with right lower quadrant pain. Laparoscopic appendectomy is planned due to presumed acute appendicitis. On exploration of the abdomen, the appendix is normal, but the terminal ileum is markedly inflamed with creeping fat of the mesentery...
Last Updated January 1, 0001
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...You are an R-3 at a large urban hospital. You are called to see a 30-year-old man with right lower quadrant pain who has newly arrived in America. You communicate through a Spanish interpreter. You are quite certain that the man has appendicitis and should have an emergent appendectomy. After...
Last Updated January 1, 0001
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...You are performing a laparoscopic appendectomy in a healthy 10-year-old girl and you discover a mass in the appendix. How would you manage this patient if the mass was 1.5 cm and at the tip? What if it was 1.5 cm and at the base? What if it was 2.5 cm in the middle? If pathology demonstrates 1.8-cm...
Last Updated September 1, 2021
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...How will you manage a patient with suspected perforated appendicitis seen on CT scan? Interval appendectomy is typically performed 6 weeks to 3 months after initial presentation and after resolution of inflammation but before risk of recurrent appendicitis....
Last Updated May 24, 2023
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...One week after laparoscopic appendectomy, a 28-year-old woman comes to your office complaining of diarrhea, fever, and lower abdominal pain. What will you do? Consider the bacteriology of pelvic abscess and the appropriate antibiotics for treatment....
Last Updated January 1, 0001
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...A 25-year-old woman underwent a laparoscopic appendectomy 10 days ago for perforated appendicitis. She presents to the emergency department with nausea, vomiting, fever, and abdominal pain. Her incisions are clean, dry, and healing without evidence of erythema or drainage. What is your approach to...
Last Updated March 17, 2023
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...A 27-year-old patient presents to the ED on POD 5 after undergoing a laparoscopic appendectomy for acute appendicitis. Although the patient initially recovered well, they now report 24 hours of profuse, watery diarrhea, fever, crampy abdominal pain, and nausea. The medical record indicates that the...
Last Updated June 30, 2023
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...A 68-year-old man with a known history of cardiomyopathy undergoes laparoscopic appendectomy for perforated appendicitis. He is found to be acutely short of breath, confused, and hypotensive in the postanesthesia care unit. Describe the use of invasive hemodynamic monitors in the diagnosis and...
Last Updated January 1, 0001
Videos
5 minutes, 50 seconds
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... study.
For example, a patient who underwent an appendectomy develops a surgical site infection (SSI).
Case series – Aims to highlight that these events can occur more than once. A case series also has the potential to uncover unrecognized benefits or adverse effects...
Last Updated September 15, 2023
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...A 22-year-old man is on the ward following open appendectomy. He has been receiving an oral cephalosporin for superficial infection of his skin incision. The wound was opened 1 week ago, and there is no longer any surrounding cellulitis. He has mild diarrhea, and per hospital protocol, the nurse...
Last Updated January 1, 0001
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... appendectomy for nonperforated appendicitis. How should treatment of this patient proceed? Discuss how management might change if the CD4 count was 240....
Last Updated January 1, 0001
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...A 7-year-old boy undergoes laparoscopic appendectomy for a classic presentation of acute appendicitis. A normal appendix is found along with purulent ascites in the pelvis. What should be your next step? Describe the most common location for a Meckel diverticulum, and recognize the need to examine...
Last Updated August 30, 2021
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...You are caring for a 32-year-old patient with a remote history of left ovarian torsion (repaired laparoscopically without oophorectomy), an appendectomy for acute appendicitis, and a known saccular 1.8-m right RAA discovered incidentally 8 months ago during a diagnostic workup of acute appendicitis...
Last Updated September 19, 2023
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...Mr. Smith is a 25-year-old gay African American man who is postoperative day 1 from a laparoscopic appendectomy surgery— the first time he has had surgery. The surgical team plans to discharge him home today. However, he does not feel that he is well enough to leave the hospital yet, and his...
Last Updated February 8, 2023
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...A 24-year-old woman presents to the emergency department with a 5-day history of right lower quadrant pain, nausea, and vomiting. What is your approach to managing this patient? Discuss the role of immediate appendectomy and delayed appendectomy and when medical management without operation may be...
Last Updated January 1, 0001
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...? What would you do if intestinal rotation was normal, and the adrenal hemorrhage was externally compressing the duodenum? What if malrotation with volvulus were present? Continue with a Ladd procedure, including division of Ladd's bands, broadening the small bowel mesentery, and appendectomy....
Last Updated August 17, 2023
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...A 28-year-old man with acute appendicitis presents for appendectomy. He is febrile, diaphoretic, and tachycardic. What intraoperative vital sign monitoring is appropriate for this patient? Identify standard monitors for general anesthesia: pulse oximeter, ECG, noninvasive blood pressure...
Last Updated January 1, 0001
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...A 22-year-old woman has just arrived on the floor following a laparoscopic appendectomy. The nurse states the woman has already received 10 mg of morphine in the PACU but is still complaining of pain. In addition, she has severe pruritus as well as nausea and vomiting. What will you do? Describe...
Last Updated January 1, 0001
CHAPTER
from Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice, 21e
Webinars
57 minutes, 30 seconds,
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...While you are on call overnight, the nurse pages you that a patient who underwent a routine laparoscopic appendectomy the day before has become acutely short of breath. On your evaluation, the patient is diaphoretic and has increased work of breathing. Blood pressure is 230/135 mm Hg, and initial...
Last Updated July 24, 2023
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... bowel mesentery
Appendectomy, because the cecum is now in the patient’s left abdomen
...
Last Updated January 1, 0001
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...Anatomy/Histology Appendiceal Neoplasms
In a patient who undergoes appendectomy with final pathology revealing an appendiceal carcinoma, counsel the patient regarding the proper treatment of this condition based on tumor size, anatomic location, and histology.
The appendix...
Last Updated March 22, 2023
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... bands
Widening of the mesenteric base by continuing to divide any adhesions between the cecum and duodenum
Resection of any frankly necrotic bowel
Performance of appendectomy
The cecum is placed in the left upper quadrant, making a future diagnosis of...
Last Updated August 30, 2021
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...A 35-year-old man undergoes laparoscopy for presumed appendicitis. The appendix is normal. How do you proceed? Appendectomy should be strongly considered to prevent an unclear picture in the future....
Last Updated March 22, 2023
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... fluoroquinolone
Small and large intestine
Appendectomy (uncomplicated appendicitis)
Nonobstructed small intestine
Obstructed small intestine
...
Last Updated March 21, 2023
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...A 35-year-old man with a history of previous open appendectomy presents to the ED with abdominal pain, nausea, and vomiting 2 weeks after undergoing an anterior iliac crest bone harvest for the reconstruction of a maxillary defect. What is your workup and treatment of this patient? Understand the...
Last Updated February 2, 2023
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...Epidemiology Given a previously healthy 7-year-male who is found to have a bowel obstruction secondary to ileo-colic intussusception two weeks following laparoscopic appendectomy whereby the appendix was divided with a GIA stapler, the resident should be able to describe causes of pathologic lead...
Last Updated August 17, 2023
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... uncomplicated appendicitis should be treated with appendectomy....
Last Updated August 15, 2023
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.... Temporary ileal diversion is also an option in this setting but generally not necessary.
Ileopexy is not necessary when the intussusception has been successfully reduced because this has not been shown to effectively reduce recurrence rates.
It is common practice to perform an appendectomy...
Last Updated August 30, 2021
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... cystic mass in the lower abdomen? Realize that this child will need to undergo an appendectomy if he is diagnosed with acute appendicitis and that you will need input from the neurosurgical team regarding his shunt. ...
Last Updated September 1, 2021