The Experts below are selected from a list of 27 Experts worldwide ranked by ideXlab platform

Jeffrey C. Pence - One of the best experts on this subject based on the ideXlab platform.

  • Ultrasound-guided transrectal drainage of deep pelvic Abscesses in children: a modified and simplified technique
    Pediatric Radiology, 2015
    Co-Authors: Janice D. Mcdaniel, Mark T. Warren, Jeffrey C. Pence
    Abstract:

    Background Appendicitis is a common cause of acute surgical abdomen in children and often presents after perforation. Intra-abdominal Abscesses can be drained percutaneously via transabdominal, transgluteal or, in the case of deep Pelvis Abscess, via transrectal approach. Objective To describe a modification of previously described techniques for transrectal drainage procedures, which involves the use of a transvaginal probe and a modified enema tip as a guide for the one-step trocar technique. We also aimed to evaluate the safety and effectiveness of this modified technique for drainage of deep pelvic Abscesses in children. Materials and methods A retrospective review of medical records was performed to identify all patients who underwent transrectal Abscess drainage at our pediatric institution during a 5-year period. Surgical and radiologic procedure notes and imaging studies were evaluated. The data were analyzed to determine technical and clinical success rates, and to evaluate for any procedure-related complication. Results The study population consisted of 46 patients with a mean age of 10.9 years. Of the 46 children, 20 underwent transrectal Abscess drainage solely using transrectal US for guidance; 2 also underwent minimal fluoroscopy at the time of transrectal drainage. Fifteen children required placement of one or more percutaneous transabdominal drains at the same time as transrectal catheter placement, and nine required addition percutaneous drainage catheters placed at another time. All transrectal drainage procedures were technically and clinically successful. There were no procedure-related complications. Conclusion The described modified technique for US-guided transrectal drainage of deep pelvic Abscesses resulting from perforated appendicitis in children is safe, effective and relatively easy to perform, with the added benefit of omitting radiation exposure in children.

  • Ultrasound-guided transrectal drainage of deep pelvic Abscesses in children: a modified and simplified technique
    Pediatric radiology, 2014
    Co-Authors: Janice D. Mcdaniel, Mark T. Warren, Jeffrey C. Pence
    Abstract:

    Background Appendicitis is a common cause of acute surgical abdomen in children and often presents after perforation. Intra-abdominal Abscesses can be drained percutaneously via transabdominal, transgluteal or, in the case of deep Pelvis Abscess, via transrectal approach.

Janice D. Mcdaniel - One of the best experts on this subject based on the ideXlab platform.

  • Ultrasound-guided transrectal drainage of deep pelvic Abscesses in children: a modified and simplified technique
    Pediatric Radiology, 2015
    Co-Authors: Janice D. Mcdaniel, Mark T. Warren, Jeffrey C. Pence
    Abstract:

    Background Appendicitis is a common cause of acute surgical abdomen in children and often presents after perforation. Intra-abdominal Abscesses can be drained percutaneously via transabdominal, transgluteal or, in the case of deep Pelvis Abscess, via transrectal approach. Objective To describe a modification of previously described techniques for transrectal drainage procedures, which involves the use of a transvaginal probe and a modified enema tip as a guide for the one-step trocar technique. We also aimed to evaluate the safety and effectiveness of this modified technique for drainage of deep pelvic Abscesses in children. Materials and methods A retrospective review of medical records was performed to identify all patients who underwent transrectal Abscess drainage at our pediatric institution during a 5-year period. Surgical and radiologic procedure notes and imaging studies were evaluated. The data were analyzed to determine technical and clinical success rates, and to evaluate for any procedure-related complication. Results The study population consisted of 46 patients with a mean age of 10.9 years. Of the 46 children, 20 underwent transrectal Abscess drainage solely using transrectal US for guidance; 2 also underwent minimal fluoroscopy at the time of transrectal drainage. Fifteen children required placement of one or more percutaneous transabdominal drains at the same time as transrectal catheter placement, and nine required addition percutaneous drainage catheters placed at another time. All transrectal drainage procedures were technically and clinically successful. There were no procedure-related complications. Conclusion The described modified technique for US-guided transrectal drainage of deep pelvic Abscesses resulting from perforated appendicitis in children is safe, effective and relatively easy to perform, with the added benefit of omitting radiation exposure in children.

  • Ultrasound-guided transrectal drainage of deep pelvic Abscesses in children: a modified and simplified technique
    Pediatric radiology, 2014
    Co-Authors: Janice D. Mcdaniel, Mark T. Warren, Jeffrey C. Pence
    Abstract:

    Background Appendicitis is a common cause of acute surgical abdomen in children and often presents after perforation. Intra-abdominal Abscesses can be drained percutaneously via transabdominal, transgluteal or, in the case of deep Pelvis Abscess, via transrectal approach.

Douglas C. Barnhart - One of the best experts on this subject based on the ideXlab platform.

  • Development and Implications of an Evidence-based and Public Health-relevant Definition of Complicated Appendicitis in Children.
    Annals of surgery, 2020
    Co-Authors: Danielle B. Cameron, Seema P. Anandalwar, Dionne A. Graham, Patrice Melvin, Stephanie K. Serres, Jonathan L. Dunlap, Mark A. Kashtan, Matt Hall, Jacqueline M. Saito, Douglas C. Barnhart
    Abstract:

    OBJECTIVE To characterize the influence of intraoperative findings on complications and resource utilization as a means to establish an evidence-based and public health-relevant definition for complicated appendicitis. SUMMARY OF BACKGROUND DATA Consensus is lacking surrounding the definition of complicated appendicitis in children. Establishment of a consensus definition may have implications for standardizing the reporting of clinical research data and for refining reimbursement guidelines. METHODS This was a retrospective cohort study of patients ages 3 to 18 years who underwent appendectomy from January 1, 2013 to December 31, 2014 across 22 children's hospitals (n = 5002). Intraoperative findings and clinical data from the National Surgical Quality Improvement Program-Pediatric Appendectomy Pilot Database were merged with cost data from the Pediatric Health Information System Database. Multivariable regression was used to examine the influence of 4 intraoperative findings [visible hole (VH), diffuse fibrinopurulent exudate (DFE) extending outside the right lower quadrant (RLQ)/Pelvis, Abscess, and extra-luminal fecalith] on complication rates and resource utilization after controlling for patient and hospital-level characteristics. RESULTS At least 1 of the 4 intraoperative findings was reported in 26.6% (1333/5002) of all cases. Following adjustment, each of the 4 findings was independently associated with higher rates of adverse events compared with cases where the findings were absent (VH: OR 5.57 [95% CI 3.48-8.93], DFE: OR 4.65[95% CI 2.91-7.42], Abscess: OR 8.96[95% CI 5.33-15.08], P < 0.0001, fecalith: OR 5.01[95% CI 2.02-12.43], P = 0.001), and higher rates of revisits (VH: OR 2.02 [95% CI 1.34-3.04], P = 0.001, DFE: OR 1.59[95% CI 1.07-2.37], P = 0.02, Abscess: OR 2.04[95% CI 1.2-3.49], P = 0.01, fecalith: OR 2.31[95% CI 1.06-5.02], P = 0.04). Each of the 4 findings was also independently associated with increased resource utilization, including longer cumulative length of stay (VH: Rate ratio [RR] 3.15[95% CI 2.86-3.46], DFE: RR 3.06 [95% CI 2.83-3.13], Abscess: RR 3.94 [95% CI 3.55-4.37], fecalith: RR 2.35 [95% CI 1.87-2.96], P =  < 0.0001) and higher cumulative hospital cost (VH: RR 1.97[95% CI 1.64-2.37], P < 0.0001, DFE: RR 1.8[95% CI 1.55-2.08], P =  < 0.0001, Abscess: RR 2.02[95% CI 1.61-2.53], P < 0.0001, fecalith: RR 1.49[95% CI 0.98-2.28], P = 0.06) compared with cases where the findings were absent. CONCLUSION AND RELEVANCE The presence of a visible hole, diffuse fibrinopurulent exudate, intra-abdominal Abscess, and extraluminal fecalith were independently associated with markedly worse outcomes and higher cost in children with appendicitis. The results of this study provide an evidence-based and public health-relevant framework for defining complicated appendicitis in children.

Mark T. Warren - One of the best experts on this subject based on the ideXlab platform.

  • Ultrasound-guided transrectal drainage of deep pelvic Abscesses in children: a modified and simplified technique
    Pediatric Radiology, 2015
    Co-Authors: Janice D. Mcdaniel, Mark T. Warren, Jeffrey C. Pence
    Abstract:

    Background Appendicitis is a common cause of acute surgical abdomen in children and often presents after perforation. Intra-abdominal Abscesses can be drained percutaneously via transabdominal, transgluteal or, in the case of deep Pelvis Abscess, via transrectal approach. Objective To describe a modification of previously described techniques for transrectal drainage procedures, which involves the use of a transvaginal probe and a modified enema tip as a guide for the one-step trocar technique. We also aimed to evaluate the safety and effectiveness of this modified technique for drainage of deep pelvic Abscesses in children. Materials and methods A retrospective review of medical records was performed to identify all patients who underwent transrectal Abscess drainage at our pediatric institution during a 5-year period. Surgical and radiologic procedure notes and imaging studies were evaluated. The data were analyzed to determine technical and clinical success rates, and to evaluate for any procedure-related complication. Results The study population consisted of 46 patients with a mean age of 10.9 years. Of the 46 children, 20 underwent transrectal Abscess drainage solely using transrectal US for guidance; 2 also underwent minimal fluoroscopy at the time of transrectal drainage. Fifteen children required placement of one or more percutaneous transabdominal drains at the same time as transrectal catheter placement, and nine required addition percutaneous drainage catheters placed at another time. All transrectal drainage procedures were technically and clinically successful. There were no procedure-related complications. Conclusion The described modified technique for US-guided transrectal drainage of deep pelvic Abscesses resulting from perforated appendicitis in children is safe, effective and relatively easy to perform, with the added benefit of omitting radiation exposure in children.

  • Ultrasound-guided transrectal drainage of deep pelvic Abscesses in children: a modified and simplified technique
    Pediatric radiology, 2014
    Co-Authors: Janice D. Mcdaniel, Mark T. Warren, Jeffrey C. Pence
    Abstract:

    Background Appendicitis is a common cause of acute surgical abdomen in children and often presents after perforation. Intra-abdominal Abscesses can be drained percutaneously via transabdominal, transgluteal or, in the case of deep Pelvis Abscess, via transrectal approach.

Danielle B. Cameron - One of the best experts on this subject based on the ideXlab platform.

  • Development and Implications of an Evidence-based and Public Health-relevant Definition of Complicated Appendicitis in Children.
    Annals of surgery, 2020
    Co-Authors: Danielle B. Cameron, Seema P. Anandalwar, Dionne A. Graham, Patrice Melvin, Stephanie K. Serres, Jonathan L. Dunlap, Mark A. Kashtan, Matt Hall, Jacqueline M. Saito, Douglas C. Barnhart
    Abstract:

    OBJECTIVE To characterize the influence of intraoperative findings on complications and resource utilization as a means to establish an evidence-based and public health-relevant definition for complicated appendicitis. SUMMARY OF BACKGROUND DATA Consensus is lacking surrounding the definition of complicated appendicitis in children. Establishment of a consensus definition may have implications for standardizing the reporting of clinical research data and for refining reimbursement guidelines. METHODS This was a retrospective cohort study of patients ages 3 to 18 years who underwent appendectomy from January 1, 2013 to December 31, 2014 across 22 children's hospitals (n = 5002). Intraoperative findings and clinical data from the National Surgical Quality Improvement Program-Pediatric Appendectomy Pilot Database were merged with cost data from the Pediatric Health Information System Database. Multivariable regression was used to examine the influence of 4 intraoperative findings [visible hole (VH), diffuse fibrinopurulent exudate (DFE) extending outside the right lower quadrant (RLQ)/Pelvis, Abscess, and extra-luminal fecalith] on complication rates and resource utilization after controlling for patient and hospital-level characteristics. RESULTS At least 1 of the 4 intraoperative findings was reported in 26.6% (1333/5002) of all cases. Following adjustment, each of the 4 findings was independently associated with higher rates of adverse events compared with cases where the findings were absent (VH: OR 5.57 [95% CI 3.48-8.93], DFE: OR 4.65[95% CI 2.91-7.42], Abscess: OR 8.96[95% CI 5.33-15.08], P < 0.0001, fecalith: OR 5.01[95% CI 2.02-12.43], P = 0.001), and higher rates of revisits (VH: OR 2.02 [95% CI 1.34-3.04], P = 0.001, DFE: OR 1.59[95% CI 1.07-2.37], P = 0.02, Abscess: OR 2.04[95% CI 1.2-3.49], P = 0.01, fecalith: OR 2.31[95% CI 1.06-5.02], P = 0.04). Each of the 4 findings was also independently associated with increased resource utilization, including longer cumulative length of stay (VH: Rate ratio [RR] 3.15[95% CI 2.86-3.46], DFE: RR 3.06 [95% CI 2.83-3.13], Abscess: RR 3.94 [95% CI 3.55-4.37], fecalith: RR 2.35 [95% CI 1.87-2.96], P =  < 0.0001) and higher cumulative hospital cost (VH: RR 1.97[95% CI 1.64-2.37], P < 0.0001, DFE: RR 1.8[95% CI 1.55-2.08], P =  < 0.0001, Abscess: RR 2.02[95% CI 1.61-2.53], P < 0.0001, fecalith: RR 1.49[95% CI 0.98-2.28], P = 0.06) compared with cases where the findings were absent. CONCLUSION AND RELEVANCE The presence of a visible hole, diffuse fibrinopurulent exudate, intra-abdominal Abscess, and extraluminal fecalith were independently associated with markedly worse outcomes and higher cost in children with appendicitis. The results of this study provide an evidence-based and public health-relevant framework for defining complicated appendicitis in children.