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Journal of Anatomy Nov 2021The cecal appendix had been considered as a useless vestige since Darwin's work, but recent research questioned this idea demonstrating that the cecal appendix appeared...
The cecal appendix had been considered as a useless vestige since Darwin's work, but recent research questioned this idea demonstrating that the cecal appendix appeared among the mammals at least 80 million years ago and has made multiple and independent appearances without any obvious correlation with diet, social life, ecology, or size of the cecum. However, functions and probable selective advantage conferred by this anatomical structure still remain enigmatic. We found, through analyses of data on 258 mammalian species, that cecal appendix presence is correlated with increased maximal observed longevity. This is the first demonstration of a correlation between cecal appendix presence and life history. Interestingly, the classical evolutionary theory of aging that predicts an increased longevity when the extrinsic mortality is reduced has been questioned several times, but recent comparative studies asserted its validity in the taxa, which experience age-dependent and density-dependent mortality, as in mammals. Thus, the cecal appendix may contribute to the increase in longevity through a reduction of extrinsic mortality. A lower risk of fatal infectious diarrhea is one of the most plausible hypotheses that could explain it. However, several hypotheses coexist about the possible functions of the cecal appendix, and our results provide new insights about this much-disputed question. In addition, we show that the cecal appendix arose at least 16 times and was lost only once during the evolutionary history of the considered mammals, an asymmetry that supports the existence of a positive selective of this structure.
Topics: Aging; Animals; Appendix; Biological Evolution; Longevity; Mammals
PubMed: 34235746
DOI: 10.1111/joa.13501 -
American Journal of Clinical Pathology Jun 2022We investigate the number of autopsy reports that did or did not document the presence or absence of the gallbladder or appendix or document abdominal scars in patients...
OBJECTIVES
We investigate the number of autopsy reports that did or did not document the presence or absence of the gallbladder or appendix or document abdominal scars in patients following cholecystectomy or appendectomy. We also report gallbladder and appendix pathology at autopsy.
METHODS
Autopsy reports from patients 18 years or older autopsied at a community teaching hospital between January 1, 2009, and December 31, 2018 were reviewed. Nonabdominal autopsies were excluded. Histopathologic examination of the gallbladder and appendix was only performed if gross pathology was seen.
RESULTS
Of the 385 autopsies studied, 48 (12.5%) had cholecystectomies, of which 6 (12.5%) did not document abdominal scars. Sixty-two (16.1%) had appendectomies, of which 12 (19.4%) did not document abdominal scars. The presence or absence of the gallbladder and appendix was not documented in 6 (1.6%) and 16 (4.2%) of reports, respectively. Pathology was seen in 87 (25.8%) gallbladders and 4 (1.2%) appendixes.
CONCLUSIONS
Absence of the gallbladder or appendix is a relatively common autopsy finding. Auditing autopsy reports for documentation of their presence or absence, along with associated abdominal scars, are potential quality assurance indicators of autopsy reports. Documentation of these elements could be improved by changing the autopsy template or using synoptic reporting.
Topics: Appendectomy; Appendix; Autopsy; Cicatrix; Gallbladder; Humans
PubMed: 34871340
DOI: 10.1093/ajcp/aqab199 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2021The authors have analyzed medical histories of two patients, treated in health care facilities of Kharkiv region from 2008 to 2020. These patients underwent urgent...
The authors have analyzed medical histories of two patients, treated in health care facilities of Kharkiv region from 2008 to 2020. These patients underwent urgent appendectomy, given the existing clinic of acute appendicitis. Morphological examination of the surgical material allowed us to diagnose adenocarcinoma in one case, and neuroendocrine tumor in combination with endometriosis in the other case. Morphological examination of the surgical material in the first case revealed a moderately differentiated adenocarcinoma and diffuse neutrophilic infiltration in all layers of the appendix, and in the second case - a well-differentiated neuroendocrine tumor (G3), combined with the signs of phlegmonous-ulcerative appendicitis and loci of endometriosis. In both cases, there were no specific for the oncological process anamnestic and clinical-instrumental data, and these tumors were manifested by the clinic of acute appendicitis. Only morphological examination of the surgical material allowed identifying the pathological process. Clinical and morphological analysis of cases from the practice of malignant tumors of the appendix (neuroendocrine tumor and adenocarcinoma) will be useful and interesting for the medical community and should stimulate cancer vigilance in physicians.
Topics: Adenocarcinoma; Appendectomy; Appendiceal Neoplasms; Appendicitis; Appendix; Female; Humans
PubMed: 34090305
DOI: No ID Found -
Gastroenterology Dec 2021
Topics: Appendectomy; Appendiceal Neoplasms; Appendix; Cecal Diseases; Female; Humans; Intestinal Volvulus; Ischemia; Middle Aged; Neoplasms, Cystic, Mucinous, and Serous; Predictive Value of Tests; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 34461051
DOI: 10.1053/j.gastro.2021.08.038 -
Khirurgiia 2022To study the features of the clinic and treatment of children with infringement of the appendix in inguinal hernias in children.
OBJECTIVE
To study the features of the clinic and treatment of children with infringement of the appendix in inguinal hernias in children.
MATERIAL AND METHODS
We observed 12 children with the localization of the appendix in the right inguinal hernia. Four of them had an infringement of the appendix: two with inguinal hernia, two with sliding inguinal and femoral hernias. To verify the diagnosis, we used clinical and laboratory examinations of children with restrained inguinal hernia, ultrasound and Doppler examination of the groin and scrotum, X-ray, morphological examination of surgical materials. 4 clinical observations are presented.
RESULTS AND DISCUSSION
Difficulties in diagnosing acute appendicitis in case of infringement of the appendix in inguinal hernias in children are associated with an atypical clinical picture, which proceeds under the mask of OZO. Testicular infarction was found in 2 children with strangulated inguinal hernia and necrosis of the appendix. Combined surgery with abdominal and herniatomical access for sliding restrained hernias in 2 children made it possible to perform a radical operation and avoid severe postoperative complications.
CONCLUSIONS
1. Infringement of the appendix in inguinal hernias in children is rare. 2. The clinical picture of the restrained appendix in the hernial sac proceeds under the mask of OZJ. 3. Operative access in the groin area when the appendix is infringed in the hernial sac is the operation of choice. 4. In case of infringement of the appendix with sliding hernias (inguinal and femoral), the operation of choice can be abdominal and herniatomical approaches.
Topics: Appendicitis; Appendix; Child; Groin; Hernia, Femoral; Hernia, Inguinal; Humans; Male
PubMed: 35593632
DOI: 10.17116/hirurgia202205181 -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Apr 2022Acute appendicitis (AA) is a common cause of abdominal pain in developed countries. In patients with suspected AA, computed tomography (CT) is considered as the gold...
BACKGROUND
Acute appendicitis (AA) is a common cause of abdominal pain in developed countries. In patients with suspected AA, computed tomography (CT) is considered as the gold standard with the highest sensitivity and specificity, and it is also an im-portant modality, especially in patients with complicated AA. In this study, we aimed to evaluate age and laboratory findings, as well as specific CT findings in differentiating between perforated and non-perforated appendicitis.
METHODS
We retrospectively analyzed 252 patients diagnosed with AA and underwent appendectomy between November 2015 and December 2019 in Somalia Mogadishu Recep Tayyip Erdogan Education and Research Hospital. Patients under 18 years of age and those with no pre-operative CT scans were excluded from the study. The demographic, laboratory, CT findings, and pathological data of all patients were evaluated.
RESULTS
This study included 80 patients, 32 (40%) classified as perforated appendicitis (Group-1) and 48 (60%) as non-perforated appendicitis (Group-2). The C-reactive protein value was found to be statistically higher in Group-1 than in Group-2 (177.5±118.9 and 100.2±87.3 mg / L, respectively; p=0.001). The appendix lumen diameter (p=0.002), appendix wall defect (p<0.001), peritoneal thickening and enhancement (p<0.001), ascites (p=0.031), intra-abdominal abscess (p=0.003), jejunal thickening (p=0.019), ileal thick-ening (p=0.008), and ileus (p=0.035) values were significantly higher in Group-1. In the binominal logistic regression analysis performed with statistically significant data, an appendiceal wall defect (OR: 0.069, 95% CI=0.014-0.327, p=0.001) and peritoneal thickening and enhancement (OR: 0.131, 95% CI=0.024-0.714, p=0.019) were identified as independent variables for perforated appendicitis.
CONCLUSION
Among CT findings, appendix wall defects and peritoneal thickening and enhancement play an important role in detecting perforation.
Topics: Acute Disease; Adolescent; Appendectomy; Appendicitis; Appendix; Humans; Retrospective Studies
PubMed: 35485514
DOI: 10.14744/tjtes.2020.58991 -
Journal of Obstetrics and Gynaecology... Sep 2023To summarize the current evidence and to make recommendations for antenatal fetal health surveillance (FHS) to detect perinatal risk factors and potential fetal...
OBJECTIVE
To summarize the current evidence and to make recommendations for antenatal fetal health surveillance (FHS) to detect perinatal risk factors and potential fetal decompensation in the antenatal period and to allow for timely intervention to prevent perinatal morbidity and/or mortality.
TARGET POPULATION
Pregnant individuals with or without maternal, fetal, or pregnancy-associated perinatal risk factors for antenatal fetal decompensation.
OPTIONS
To use basic and/or advanced antenatal testing modalities, based on risk factors for potential fetal decompensation.
OUTCOMES
Early identification of potential fetal decompensation allows for interventions that may support fetal adaptation to maintain well-being or expedite delivery.
BENEFITS, HARMS, AND COSTS
Antenatal FHS in pregnant individuals with identified perinatal risk factors may reduce the chance of adverse outcomes. Given the high false-positive rate, FHS may increase unnecessary interventions, which may result in harm, including parental anxiety, premature or operative birth, and increased use of health care resources. Optimization of surveillance protocols based on evidence-informed practice may improve perinatal outcomes and reduce harm.
EVIDENCE
Medline, PubMed, Embase, and the Cochrane Library were searched from inception to January 2022, using medical subject headings (MeSH) and key words related to pregnancy, fetal monitoring, fetal movement, stillbirth, pregnancy complications, and fetal sonography. This document represents an abstraction of the evidence rather than a methodological review.
VALIDATION METHODS
The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and weak recommendations).
INTENDED AUDIENCE
All health care team members who provide care for or education to obstetrical patients, including maternal fetal medicine specialists, obstetricians, family physicians, midwives, nurses, nurse practitioners, and radiologists.
SUMMARY STATEMENTS
RECOMMENDATIONS.
Topics: Female; Pregnancy; Humans; Prenatal Care; Fetus; Parturition; Appendix; Fetal Monitoring
PubMed: 37661122
DOI: 10.1016/j.jogc.2023.05.020 -
Surgical Pathology Clinics Sep 2020Mucinous appendiceal tumors include low-grade appendiceal mucinous neoplasm, high-grade appendiceal mucinous neoplasm, and mucinous adenocarcinoma. Nonmucinous... (Review)
Review
Mucinous appendiceal tumors include low-grade appendiceal mucinous neoplasm, high-grade appendiceal mucinous neoplasm, and mucinous adenocarcinoma. Nonmucinous adenocarcinomas are less frequent. Recent consensus guidelines and the latest edition of the World Health Organization classification will allow consistent use of agreed nomenclature. Accurate diagnosis is important not only for patient management but also to allow comparison of results between centers and tumor registries. Serrated polyps are the most common benign polyp in the appendix. They need to be distinguished from low-grade appendiceal mucinous neoplasm, which can also mimic other benign conditions. Goblet cell adenocarcinomas are a distinctive type of appendiceal neoplasm.
Topics: Adenocarcinoma, Mucinous; Appendiceal Neoplasms; Appendix; Diagnosis, Differential; Humans; Neoplasm Staging; Prognosis
PubMed: 32773195
DOI: 10.1016/j.path.2020.05.006 -
Journal of Clinical Ultrasound : JCU Oct 2021While many cases of appendicitis are easy to diagnose clinically, a significant number need further workup in the form of imaging. Ultrasound and CT are both used... (Review)
Review
While many cases of appendicitis are easy to diagnose clinically, a significant number need further workup in the form of imaging. Ultrasound and CT are both used extensively to diagnose or exclude appendicitis, or arrive at an alternate diagnosis. Ultrasound has many advantages but can be a difficult modality to use due to, among other reasons, the anatomical variations in appendicial location. The true retrocolic appendix is particularly difficult to diagnose with ultrasound. This pictorial essay examines the ultrasound features of normal and diseased appendix and proposes a new examining station, the prone view, for visualizing true retrocolic appendicitis.
Topics: Appendicitis; Appendix; Diagnostic Imaging; Humans; Ultrasonography
PubMed: 34184283
DOI: 10.1002/jcu.23033 -
BMC Infectious Diseases May 2021Schistosomiasis is very common in the southern part of the Yangtze River Basin in China. It is mainly manifested as appendicitis, ulcers, hematomas, and thickening of...
BACKGROUND
Schistosomiasis is very common in the southern part of the Yangtze River Basin in China. It is mainly manifested as appendicitis, ulcers, hematomas, and thickening of the intestinal tract. Schistosomiasis of the appendix is rare, mainly manifested as appendicitis, which is easy to be misdiagnosed.
CASE PRESENTATION
Here we report a rare case of a Chinese female whose intestinal mass manifested as intestinal polyps and was eventually diagnosed pathologically as schistosomiasis infection (appendix schistosomiasis). So far, there are rare relevant cases reported.
CONCLUSIONS
Intestinal schistosomiasis is easily misdiagnosed, and appendix schistosomiasis is rare. The final diagnosis requires pathology, especially surgical pathology.
Topics: Aged; Appendix; China; Colonoscopy; Diagnostic Errors; Female; Humans; Intestinal Polyps; Schistosomiasis
PubMed: 33964884
DOI: 10.1186/s12879-021-06125-4