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      Diagnostic Accuracy of Ileocolic Artery and Vein Diameter for Acute Appendicitis

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          Abstract

          Background

          Regional inflammation-induced local vasodilation may exist in cases of appendicitis. In this study, the diameters of the ileocolic artery (ICA) and ileocolic vein (ICV) were measured using contrast-enhanced abdominal computed tomography (CT) scans in acute appendicitis cases. The study aimed to measure the diagnostic value of these measurements in the diagnosis of acute appendicitis.

          Material/Methods

          A total of 508 patients, including those with a diagnosis of acute appendicitis and a control group without appendicitis, were systematically evaluated. In all cases, the appendix was analyzed simultaneously on axial and coronal CT sections, and all measurement procedures were conducted with an electronic ruler after the actual images were magnified. Measurements of the ICA and ICV diameters were taken from the proximal 2-cm segments of the superior mesenteric artery and superior mesenteric vein in the axial plane. Demographic information, sex distribution, and ICA and ICV diameters were collected.

          Results

          Of the 508 patients, 53.74% were men, and 46.26% were women. ICA and ICV diameters were significantly increased in the appendicitis group ( P<0.001). Binomial logistic regression confirmed the independent predictive value of ICA and ICV diameters. Receiver operating characteristic curve analysis determined optimal cut-off values for distinguishing between the non-appendicitis and appendicitis groups (ICA: 2.475 mm, ICV: 3.885 mm) with high sensitivity and specificity.

          Conclusions

          ICA and ICV diameter measurements, in conjunction with major radiological findings, can enhance diagnostic accuracy in acute appendicitis cases. The use of ICA and ICV diameter measurements in diagnosing acute appendicitis offers a novel perspective in clinical practice.

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          Most cited references26

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          The epidemiology of appendicitis and appendectomy in the United States.

          To describe the epidemiology of appendicitis and appendectomy in the United States, the authors analyzed National Hospital Discharge Survey data for the years 1979-1984. Approximately 250,000 cases of appendicitis occurred annually in the United States during this period, accounting for an estimated 1 million hospital days per year. The highest incidence of primary positive appendectomy (appendicitis) was found in persons aged 10-19 years (23.3 per 10,000 population per year); males had higher rates of appendicitis than females for all age groups (overall rate ratio, 1.4:1). Racial, geographic, and seasonal differences were also noted. Appendicitis rates were 1.5 times higher for whites than for nonwhites, highest (15.4 per 10,000 population per year) in the west north central region, and 11.3% higher in the summer than in the winter months. The highest rate of incidental appendectomy was found in women aged 35-44 years (43.8 per 10,000 population per year), 12.1 times higher than the rate for men of the same age. Between 1970 and 1984, the incidence of appendicitis decreased by 14.6%; reasons for this decline are unknown. A life table model suggests that the lifetime risk of appendicitis is 8.6% for males and 6.7% for females; the lifetime risk of appendectomy is 12.0% for males and 23.1% for females. Overall, an estimated 36 incidental procedures are performed to prevent one case of appendicitis; for the elderly, the preventive value of an incidental procedure is considerably lower.
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            Inflammation and the blood microvascular system.

            Acute and chronic inflammation is associated with changes in microvascular form and function. At rest, endothelial cells maintain a nonthrombogenic, nonreactive surface at the interface between blood and tissue. However, on activation by proinflammatory mediators, the endothelium becomes a major participant in the generation of the inflammatory response. These functions of endothelium are modified by the other cell populations of the microvessel wall, namely pericytes, and smooth muscle cells. This article reviews recent advances in understanding the roles played by microvessels in inflammation.
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              Diagnosis and Management of Acute Appendicitis in Adults : A Review

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                Author and article information

                Journal
                Med Sci Monit
                Med Sci Monit
                Medical Science Monitor
                Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
                International Scientific Literature, Inc.
                1234-1010
                1643-3750
                2024
                01 March 2024
                16 February 2024
                : 30
                : e943846-1-e943846-6
                Affiliations
                Department of General Surgery, Erol Olcok Training and Research Hospital, Hitit University, Çorum, Turkey
                Author notes
                Corresponding Author: Bahadir Kartal, e-mail: dr.bkartal@ 123456hotmail.com
                [A]

                Study Design

                [B]

                Data Collection

                [C]

                Statistical Analysis

                [D]

                Data Interpretation

                [E]

                Manuscript Preparation

                [F]

                Literature Search

                [G]

                Funds Collection

                Author information
                https://orcid.org/0000-0003-1647-9979
                https://orcid.org/0000-0003-1834-7355
                https://orcid.org/0000-0002-3044-5428
                https://orcid.org/0000-0002-3921-7675
                https://orcid.org/0000-0001-5093-4993
                Article
                943846
                10.12659/MSM.943846
                10913285
                38425035
                e4a49ea6-4ec6-48cf-b44c-ed1672a34d95
                © Med Sci Monit, 2024

                This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International ( CC BY-NC-ND 4.0)

                History
                : 17 January 2024
                : 08 February 2024
                Categories
                Clinical Research

                appendicitis,abdomen, acute,diagnosis,mesenteric artery, superior,mesenteric veins,computed tomography angiography

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