Understanding pediatric appendicitis: A-mini review

Mustafa Atan, Serkan Arslan — Tue, 25 Jul 2023 00:00:00 +0300

Appendicitis, an inflammation of the appendix, is a common surgical emergency in children, with symptoms ranging from abdominal pain and fever to changes in bowel movements and appetite. Diagnosing pediatric appendicitis can be challenging due to symptom variability and the difficulty children may have in articulating pain. However, prompt diagnosis and treatment are essential to avoid severe complications like gangrene or perforation. The condition is usually caused by blockage in the appendix due to hardened stool, swollen lymphoid tissues from infections, or, rarely, foreign bodies. Diagnosis typically involves a combination of medical history, physical examination, and diagnostic tests including blood counts, urinalysis, and imaging studies such as ultrasound, CT scans, or MRI.

Treatment primarily involves an appendectomy, either through open surgery or a laparoscopic approach, with the latter now considered the gold standard due to benefits like less post-operative pain and shorter recovery time. In some cases of uncomplicated appendicitis, non-operative management with antibiotics and close monitoring may be pursued, although there's a risk of recurrence.

Postoperative care is vital and includes pain management, wound care, a gradual return to a normal diet, and a cautious return to physical activities. Despite the commonality of pediatric appendicitis, swift action in diagnosis and intervention, coupled with proper post-operative care, ensures a complete recovery and normal continuation of growth and development.

Acute post-streptococcal glomerulonephritis

Süleyman Çelik — Mon, 15 May 2023 00:00:00 +0300

Acute post-streptococcal glomerulonephritis (APSGN) is an immune-mediated renal disorder that occurs following an infection with certain strains of group A beta-hemolytic streptococci. This essay provides a comprehensive analysis of APSGN, covering its definition, causes, pathophysiology, clinical presentation, diagnosis, treatment, and prognosis.

APSGN arises 1-3 weeks after a streptococcal infection, primarily impetigo or pharyngitis caused by Streptococcus pyogenes. The immune response leads to the deposition of immune complexes in the glomeruli, activating complement and causing glomerular inflammation and injury.

Patients with APSGN commonly exhibit edema, hematuria, hypertension, and other symptoms such as oliguria, fatigue, and malaise. Diagnosis involves evaluating clinical features, laboratory findings, and serological tests. Urinalysis reveals hematuria, red blood cell casts, and proteinuria, while blood tests show elevated serum creatinine levels, decreased serum complement levels, and the presence of antistreptolysin O titers.

Management of APSGN focuses on supportive care and treating complications. Hospitalization may be necessary for severe cases, and measures include fluid and electrolyte balance, diuretics, and antihypertensive medications. Antibiotic therapy is generally not required unless an active streptococcal infection is present.

The prognosis for APSGN is generally favorable, with most patients experiencing complete recovery within weeks to months. However, chronic kidney disease can occur in rare cases. Complications may include hypertension, acute kidney injury, fluid overload, infections, and glomerular scarring.

Preventing APSGN involves timely diagnosis and treatment of streptococcal infections. Antibiotics, such as penicillin or erythromycin, help eradicate the bacteria, while good hygiene practices reduce the spread of streptococcal infections.

In conclusion, APSGN is an immune-mediated glomerulonephritis following streptococcal infection. Diagnosis relies on clinical presentation and laboratory tests, and treatment focuses on supportive care. Most cases have a favorable prognosis, highlighting the importance of preventive measures in reducing the incidence of APSGN.

Unico's Review

Understanding pediatric appendicitis: A-mini review

Acute post-streptococcal glomerulonephritis