スエヨシ　リヨウ   末吉　亮    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Perforation in pediatric non-complicated appendicitis treated by antibiotics: the real incidence.
掲載誌名	正式名：Pediatric surgery international 略　 称：Pediatr Surg Int ISSNコード：14379813/01790358
掲載区分	国外
巻・号・頁	36(1),pp.69-74
著者・共著者	Mikami Takafumi, Sueyoshi Ryo, Kosaka Seitaro, Yoshida Shiho, Miyano Go, Ochi Takanori, Koga Hiroyuki, Okazaki Tadaharu, Yanai Toshihiro, Urao Masahiko, Lane Geoffrey, Jimbo Keisuke, Suzuki Kazuhiro, Kuwatsuru Ryohei, Shimizu Toshiaki, Yamataka Atsuyuki
担当区分	2nd著者
発行年月	2020/01
概要	PURPOSE:The incidence of perforation during antibiotic therapy (AT) of children triaged as non-complicated acute appendicitis (NC-Ap) was investigated.METHODS:Abdominal ultrasonography (US) and/or computed tomography (CT) scans from cases of perforation identified at appendectomy for failed AT were reassessed blindly by a panel of board-certified specialists for any evidence of pre-AT morbidity suggestive of perforation.RESULTS:Of 521 cases triaged as NC-Ap, symptoms resolved with AT in 452 cases (86.8%). All 69/521 (13.2%) cases with persistent symptoms had urgent appendectomy, and 12/521 (2.3%) were found to have perforated. Blind reassessment of US and/or CT scans from these cases identified seven with evidence of perforation when they were triaged as NC-Ap. Thus, the actual incidence of perforation during AT for NC-Ap was actually 12-7 = 5/521 (0.95%).CONCLUSIONS:Perforation is generally believed to be a complication of AT, but inappropriate triaging of cases for AT can bias results by artificially inflating the number of perforations, in this study, by more than double. We are the first to assess the unbiased incidence of perforation during AT for NC-Ap, by reassessing pre-AT US and/or CT scans. The incidence of perforation during AT is actually negligible.
DOI	10.1007/s00383-019-04574-2
PMID	31576464