[download] Advances in the Diagnosis and Management of Appendicitis in Children [pdf]

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Advances in the Diagnosis and Management of Appendicitis in Children Download

Katherine He et al

Appendicitis is the most common surgical emergency in childhood and amongall pediatric surgical conditions, it is associated with the greatest relative burdenof hospital cost, surgical site infections, hospital revisits, and antibiotictreatment days [1–3]. Over the past decade, significant advances have beenmade in the ability to diagnose appendicitis while minimizing the need forionizing radiation. These have included strategies to improve the diagnosticquality of ultrasound (US), leveraging the combined predictive value of multi-ple sources of diagnostic data, and use of multidisciplinary clinical pathways.Advances in management have included availability of more robust compara-tive data to guide antibiotic treatment, same-day discharge protocols toimprove health care value, and opioid-sparing pain management strategies,among others. Nonoperative management has also emerged as a viable andsafe treatment option for children with early, uncomplicated appendicitis.Finally, expansion of the American College of Surgeon’s Pediatric NationalSurgical Quality Improvement Program (NSQIP-Pediatric) to capture appen-dectomy measures has led to the development of performance and resource uti-lization benchmarks to help hospitals prioritize their quality improvementefforts. The purpose of this review is to summarize these recent advancesand review ongoing controversies as a framework for future investigation

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