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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.
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 ...
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.
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]
Common causes of an acute abdomen include a gastrointestinal perforation, peptic ulcer disease, mesenteric ischemia, acute cholecystitis, appendicitis, diverticulitis, pancreatitis, and an abdominal hemorrhage. However, this is a non-exhaustative list and other less common causes may also lead to an acute abdomen. [2]
Before delivery treatment of the mother with antibiotics reduces the rate of neonatal infection. [31] Prevention of the infection of the baby is done by treating the mother with penicillin. Since the adoption of this prophylactic treatment, infant mortality from GBS infection has decreased by 80%. [36]
Surgical treatment is usually required due to the likelihood of stenosis or complete occlusion of the small intestine. [17] Ischemic damage can range from mucosal infarction , which is limited only to the mucosa; mural infarction of the mucosa and underlying submucosa ; to transmural infarction of the full thickness of the gastrointestinal wall.
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