Akute Appendizitis - Verlässligkeit der präoperativen Diagnostik, chirurgisches Management und Vergleich des intraoperativen und histopathologischen Befundes

Acute appendicitis - reliability of preoperative evaluation, surgical management and comparison of intraoperative and histopathological findings

by Ulrike Kopsch
Doctoral thesis
Date of Examination:2016-09-19
Date of issue:2016-07-15
Advisor:Prof. Dr. Otto Kollmar
Referee:Prof. Dr. Otto Kollmar
Referee:Prof. Dr. Dr. Martin Bauer
Persistent Address: http://dx.doi.org/10.53846/goediss-5743

 

 

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Abstract

English

Acute appendicitis is one of the most common causes of acute abdomen. Correct diagnosis and treatment is a surgical responsibility and is of high value within the surgical emergency care. Due to diverse clinical manifestations of acute appendicitis there is a need to determine reliable preoperative predictors and a clearly defined time for surgical therapy as well as to investigate reliability of intraoperative evaluation of the appendix. This retrospective study included 655 patients having an appendectomy from January 2008 to April 2013 in the UMG. It is evident that acute appendicitis and postoperative complicated disease outcomes can be predicted through anamnestic patient survey, parameters of clinical examination, abdominal ultrasonography and laboratory chemistry. It is less a single predictor than the synopsis of the constellation of findings that is crucial for the correct diagnosis. The study further suggests that the diagnosis of acute appendicitis is an indication for timely operation because advanced appendicitis is associated with increased postoperative complication rates. However, perforation rate could not be significantly reduced by a rapid start of operation. The existing risk of intraoperatively leaving a macroscopically not recognizably inflamed appendix, suggests a demand for routine appendectomy, although ambivalent study positions on this issue do not allow clear recommendation at this point.
Keywords: acute appendicitis, acute abdomen, surgery delay; acute appendicitis, acute abdomen, surgery delay; acute appendicitis, acute abdomen, surgery delay
Schlagwörter: Akute Appendizitis, Akutes Abdomen; Akute Appendizitis, Akutes Abdomen
 
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