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Recurrent appendicitis following successful drainage of appendicular abscess in adult without interval appendectomy during COVID-19. Prospective cohort study.
Habeeb, Tamer A A M; Hussain, Abdulzahra; Schlottmann, Francisco; Kermansaravi, Mohammad; Aiolfi, Alberto; Matic, Ivan; Abdelazez, Osama; Negm, Said Mohamed; Baghdadi, Muhammad Ali; Abdou Yassin, Mahmoud; Sallam, Ahmed M; Mohammad, Hatem; Habib, Fady Mehaney; Abdelhamid, Mohamed I; Amin, Mohamed Farouk.
  • Habeeb TAAM; Department of General Surgery, Faculty of Medicine, Zagazig University, Egypt. Electronic address: tameralnaimy@hotmail.com.
  • Hussain A; Doncaster and Bassetlaw Teaching Hospitals, NHS Foundation Trust, Sheffield University, UK.
  • Schlottmann F; Department of Surgery, Hospital Alemán of Buenos Aires, Argentina.
  • Kermansaravi M; Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
  • Aiolfi A; Department of Biomedical Sciences for Health Milan, Italy.
  • Matic I; Surgery Department General Hospital Aleksinac, Serbia.
  • Abdelazez O; Department of General Surgery, Faculty of Medicine, Zagazig University, Egypt.
  • Negm SM; Department of General Surgery, Faculty of Medicine, Zagazig University, Egypt.
  • Baghdadi MA; Department of General Surgery, Faculty of Medicine, Zagazig University, Egypt.
  • Abdou Yassin M; Department of General Surgery, Faculty of Medicine, Zagazig University, Egypt.
  • Sallam AM; Department of General Surgery, Faculty of Medicine, Zagazig University, Egypt.
  • Mohammad H; Department of General Surgery, Faculty of Medicine, Zagazig University, Egypt.
  • Habib FM; Department of General Surgery, Faculty of Medicine, Zagazig University, Egypt.
  • Abdelhamid MI; Department of General Surgery, Faculty of Medicine, Zagazig University, Egypt.
  • Amin MF; Department of General Surgery, Faculty of Medicine, Zagazig University, Egypt.
Int J Surg ; 97: 106200, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1587514
ABSTRACT

BACKGROUND:

COVID-19 infection is a global pandemic that affected routine health services and made patients fear to consult for medical health problems, even acute abdominal pain. Subsequently, the incidence of complicated appendicitis increased during the Covid-19 pandemic. This study aimed to evaluate recurrent appendicitis after successful drainage of appendicular abscess during COVID-19. MATERIAL AND

METHODS:

A prospective cohort study conducted in the surgical emergency units of our Universities' Hospitals between March 15, 2020 to August 15, 2020 including patients who were admitted with the diagnosis of an appendicular abscess and who underwent open or radiological drainage. Main outcomes included incidence, severity, and risk factors of recurrent appendicitis in patients without interval appendectomy.

RESULTS:

A total of 316 patients were included for analysis. The mean age of the patients was 37 years (SD ± 13). About two-thirds of patients were males (60.1%). More than one-third (39.6%) had co-morbidities; type 2 diabetes mellitus (T2DM) (22.5%) and hypertension (17.1%) were the most frequent. Approximately one quarter (25.6%) had confirmed COVID 19 infection. About one-third of the patients (30.4%) had recurrent appendicitis. More than half of them (56.3%) showed recurrence after three months, and 43.8% of patients showed recurrence in the first three months. The most frequent grade was grade I (63.5%). Most patients (77.1%) underwent open surgery. Age, T2DM, hypertension, COVID-19 infection and abscess size >3 cm were significantly risking predictors for recurrent appendicitis.

CONCLUSIONS:

Interval appendectomy is suggested to prevent 56.3% of recurrent appendicitis that occurs after 3 months. We recommend performing interval appendectomy in older age, people with diabetes, COVID-19 infected, and abscesses more than 3 cm in diameter. RESEARCH QUESTION Is interval appendectomy preventing a high incidence of recurrent appendicitis after successful drainage of appendicular abscess during COVID-19 pandemic?
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Appendicitis / Abdominal Abscess / Diabetes Mellitus, Type 2 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Aged / Child, preschool / Humans / Male Language: English Journal: Int J Surg Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Appendicitis / Abdominal Abscess / Diabetes Mellitus, Type 2 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Aged / Child, preschool / Humans / Male Language: English Journal: Int J Surg Year: 2022 Document Type: Article