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A new analysis found that outpatient management of appendicitis with antibiotics is safe for selected patients, which may allow people to avoid hospitalization
The presentation of acute appendicitis includes acute abdominal pain, nausea, vomiting, and fever. As the appendix becomes more swollen and inflamed, it begins to irritate the adjoining abdominal wall. This leads the pain to localize at the right lower quadrant. This classic migration of pain may not appear in children under three years.
There has been significant recent trial evidence that uncomplicated appendicitis can be treated with either antibiotics or appendicectomy, [4] [5] with 51% of those treated with antibiotics avoiding an appendectomy after 3 years. [6] After appendicectomy the main difference in treatment is the length of time the antibiotics are administered.
The sensitivity and specificity of MRI in diagnosing acute appendicitis are 94% and 96% respectively. [2] Laparoscopic surgery has also been used to diagnose the cause of IAIs when imaging is unhelpful. Besides, the laparoscopic surgery can also initiate treatment in the same setting. The accuracy is very high, in the range of 86 to 100%. [2]
Treatment is with antibiotics and drainage of the abscess; typically guided by ultrasound or CT, through the skin, via the rectum, or transvaginal routes. [3] Occasionally antibiotics may be used without surgery; if the abscess is at a very stage and small. [2] Until sensitivities are received, a broad spectrum antibiotic is generally required. [2]
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The AIR score was developed to overcome some of the drawbacks of the Alvarado score, another diagnostic scoring system for identifying appendicitis. [2] The AIR score is one of the two scores (the other being the Adult Appendicitis Score , AAS) recommended by the 2020 World Society of Emergency Surgery clinical practice guidelines for the ...
Anorectal abscess (also known as an anal/rectal abscess or perianal/perirectal abscess) is an abscess adjacent to the anus. [1] Most cases of perianal abscesses are sporadic, though there are certain situations which elevate the risk for developing the disease, such as diabetes mellitus, Crohn's disease, chronic corticosteroid treatment and others.