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Complicated Appendicitis
Everything in the library about complicated appendicitis — built automatically from the recorded discussions that name it
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
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Evidence & Research
4 items
Journal of Pediatric Surgery Article Review: March 2022
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We're back with the March issue of JPS article highlights. This time we're talking to editor Dr.Mikko Pakarinen and authors Drs. Selcuk Kilic, Scott Short and Michael Rollins with Dr. Todd Ponsky. Hosts: Ellen Encisco, Em Tombash & Brittany
video · Apr 2022
Journal of Pediatric Surgery Article Review: March 2022
Listen →
We're back with the March issue of JPS article highlights. This time we're talking to editor Dr.Mikko Pakarinen and authors Drs. Selcuk Kilic, Scott Short and Michael Rollins with Dr. Todd Ponsky. Hosts: Ellen Encisco, Em Tombash & Brittany
podcast10:47 · Apr 2022
Unanticipated consequences of COVID-19 pandemic policies on pediatric acute appendicitis surgery
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New article you should know by Dr. Cecilia Gigena
"Unanticipated consequences of COVID-19 pandemic policies on pediatric acute appendicitis surgery"
Authors: Paula R. Quaglietta, Joshua K. Ramjist, Jeffrey Antwi, Ashby Kissoondoyal, E
video · Jul 2023
Journal of Pediatric Surgery Article Review: Q1 (Jan-Mar) 2024
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We are back with a new episode of the Journal of pediatric surgery series.
This time we have the first quarter of 2024.
With editors: Dr. Romeo Ignacio for January, APSA edition, Dr. Mark Davenport for February, BAPS, edition & Dr. P
podcast13:34 · Jun 2024
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Every expert statement below comes from the recorded discussions, with its speaker and moment.
Journal of Pediatric Surgery Article Review: Q1 (Jan-Mar) 2024
The appendicitis study compared two cohorts defined by time frame before and after near uniform implementation of stopping antibiotics at discharge.
clinicalScott Short2:07 ↗
The appendicitis study looked at deep space organ infections, length of stay, readmissions, and use of CT scans as outcomes.
Host summaryRomeo Ignacio summarizing the discussion — not the host's own clinical position2:33 ↗
The appendicitis study had 185 patients in the home antibiotic group and 121 patients in the no home antibiotic group.
Host summaryCecilia Gigena summarizing the discussion — not the host's own clinical position2:45 ↗
There was no significant difference in deep organ space infection requiring intervention between home antibiotic and no home antibiotic groups for complicated appendicitis.
Host summaryCecilia Gigena summarizing the discussion — not the host's own clinical position2:55 ↗
There was no difference in length of stay between home antibiotic and no home antibiotic groups for complicated appendicitis.
Host summaryCecilia Gigena summarizing the discussion — not the host's own clinical position3:03 ↗
Secondary outcomes including C. diff infections, superficial site infections, length of stay, post-operative CT imaging, and readmission showed no difference between antibiotic groups.
Host summaryRomeo Ignacio summarizing the discussion — not the host's own clinical position3:06 ↗
The appendicitis study challenges the tradition of giving antibiotics and possibly too much antibiotics after discharge.
opinionRomeo Ignacio3:17 ↗
The next step for the appendicitis study is to roll it out to the Western Pediatric Surgery Research Consortium to study it on a broader scale.
clinicalScott Short3:55 ↗
The esophageal atresia study is a 25 year experience describing 220 consecutive infants with esophageal atresia in Newcastle.
Host summaryMark Davenport summarizing the discussion — not the host's own clinical position4:44 ↗
The esophageal atresia study had 215 patients, 13% had complex esophageal atresia, and of those 25 patients survived the repair.
Host summaryEm Gootee summarizing the discussion — not the host's own clinical position5:13 ↗
Of the 25 complex esophageal atresia survivors, 14 patients were type A and 11 patients were type C.
Host summaryEm Gootee summarizing the discussion — not the host's own clinical position5:28 ↗
Type C esophageal atresia is the most common type and means esophageal atresia with a distal fistula; type A means pure esophageal atresia with no fistula to the trachea.
Host summaryCecilia Gigena summarizing the discussion — not the host's own clinical position5:43 ↗
Of the 25 complex esophageal atresia patients, 18 had delayed primary anastomosis and 7 had esophageal replacement.
Host summaryEm Gootee summarizing the discussion — not the host's own clinical position6:03 ↗
Two of the esophageal replacements were salvage procedures following a failed traction.
Host summaryEm Gootee summarizing the discussion — not the host's own clinical position6:13 ↗
Only 4 patients with esophageal atresia were potentially treatable by traction.
Host summaryEm Gootee summarizing the discussion — not the host's own clinical position6:13 ↗
The esophagus has a great intrinsic blood supply and can be mobilized right down to the diaphragm and right up to the thoracic inlet and will stay alive.
clinicalBruce Jaffray6:28 ↗
Many cases being put forward for lengthening are because surgeons get cold feet about attempting a primary anastomosis.
opinionBruce Jaffray6:46 ↗
In cases where traction techniques had not been attempted, the native esophagus was retained in 80% of cases.
Host summaryEm Gootee summarizing the discussion — not the host's own clinical position6:57 ↗
The median time to esophageal continuity in the Newcastle series was 77 days.
Host summaryEm Gootee summarizing the discussion — not the host's own clinical position7:02 ↗
Management of complex esophageal atresia without lengthening procedure can result in a similar rate of retention of the native esophagus but with significantly less morbidity.
Host summaryEm Gootee summarizing the discussion — not the host's own clinical position7:12 ↗
The Newcastle series is a pushback series which extols relatively conventional open surgery and begs the question as to what role lengthening procedures have in those with long gaps.
opinionMark Davenport7:32 ↗
Unless an experienced surgeon says after maximum mobilization they genuinely can't get the esophagus together, esophageal lengthening is not required.
opinionBruce Jaffray7:56 ↗
If esophaguses were being anastomosed with excess tension and repairs were failing, there would be a very high incidence of esophageal replacement, which is not seen in the Newcastle series.
clinicalBruce Jaffray8:09 ↗
The pectus study is a prospective cohort study from a single center in Phoenix aiming to quantify long-term hyperesthesia and neuropathic pain after minimally invasive repair of pectus excavatum with cryoablation.
Host summaryCecilia Gigena summarizing the discussion — not the host's own clinical position8:47 ↗
The pectus study selected patients under 21 years of age who presented for bar removal between November 2021 and May 2023.
Host summaryCecilia Gigena summarizing the discussion — not the host's own clinical position9:04 ↗
Testing for cold and soft touch and pinprick was performed just before bar removal.
Host summaryCecilia Gigena summarizing the discussion — not the host's own clinical position9:15 ↗
The pectus study enrolled 47 patients with a median bar dwell time of approximately 2.9 years.
Host summaryCecilia Gigena summarizing the discussion — not the host's own clinical position9:25 ↗
Patients had a median of 2 bars placed, and almost 81% were secured with pericostal sutures.
Host summaryCecilia Gigena summarizing the discussion — not the host's own clinical position9:41 ↗
Almost half of the pectus patients had some degree of hypoesthesia, with T5 being the most common dermatome affected.
Host summaryCecilia Gigena summarizing the discussion — not the host's own clinical position9:51 ↗
The area with hypoesthesia was less than 5% of the entire surface that was treated with cryo.
Host summaryCecilia Gigena summarizing the discussion — not the host's own clinical position10:00 ↗
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