{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T11:27:05Z","timestamp":1783769225650,"version":"3.55.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:p>\n            Aim\u2003To define patterns in the management of pediatric appendicitis.<\/jats:p><jats:p>\n            Methods\u2003A total of 169 delegates from 42 (24 European) countries completed a validated survey administered at the EUPSA 2017 annual congress.<\/jats:p><jats:p>\n            Results\u2003In the work-up of children with suspected acute appendicitis, most surgeons rely on full blood count (92%), C-reactive protein (82%), and abdominal ultrasonography (76%), but rarely on computed tomography scans or magnetic resonance imaging. In suspected simple appendicitis, most surgeons (76%) do not perform appendectomy at night in clinically stable patients and start antibiotic preoperatively (64%), but only 15% offer antibiotic therapy alone (no appendectomy). In suspected perforated appendicitis, 96% start antibiotic preoperatively, and 92% perform an appendectomy. Presence of phlegmon\/abscess is the main contraindication to immediate surgery. In case of appendix mass, most responders (75%) favor a conservative approach and perform interval appendectomy always (56%) or in selected cases (38%) between 2 and 6 months from the first episode (81%). Children with large intraperitoneal abscesses are managed by percutaneous drainage (59% responders) and by surgery (37% responders). Laparoscopy is the preferred surgical approach for both simple (89%) and perforated appendicitis (81%). Most surgeons send the appendix for histology (96%) and pus for microbiology, if present (78%). At the end of the operation, 58% irrigate the abdominal cavity only if contaminated using saline solution (93%). In selected cases, 52% leave a drain in situ.<\/jats:p><jats:p>\n            Conclusion\u2003Some aspects of appendicitis management lack consensus, particularly appendix mass and intraperitoneal abscess. Evidence-based guidelines should be developed, which may help standardize care and improve clinical outcomes.<\/jats:p>","DOI":"10.1055\/s-0038-1668139","type":"journal-article","created":{"date-parts":[[2018,8,16]],"date-time":"2018-08-16T05:04:57Z","timestamp":1534395897000},"page":"053-061","source":"Crossref","is-referenced-by-count":32,"title":["European Paediatric Surgeons' Association Survey on the Management of Pediatric Appendicitis"],"prefix":"10.1055","volume":"29","author":[{"given":"Nigel","family":"Hall","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Southampton, Southampton, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abidur","family":"Rahman","sequence":"first","affiliation":[{"name":"Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Morini","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Neonatology, Ospedale Pediatrico Bambino Gesu, IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio","family":"Pini Prato","sequence":"first","affiliation":[{"name":"Pediatric Surgery, The Children Hospital, AON SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Friedmacher","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, The Royal London Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antti","family":"Koivusalo","sequence":"first","affiliation":[{"name":"Section of Pediatric Surgery, Children\u2027s Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest","family":"van Heurn","sequence":"first","affiliation":[{"name":"Emma Children\u2027s Hospital AMC and VU University Medical Center, Paediatric Surgical Center of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agostino","family":"Pierro","sequence":"first","affiliation":[{"name":"Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Department of Surgery, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augusto","family":"Zani","sequence":"additional","affiliation":[{"name":"Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Department of Surgery, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2018,8,15]]},"container-title":["European Journal of Pediatric Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0038-1668139.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,1,17]],"date-time":"2019-01-17T23:37:43Z","timestamp":1547768263000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0038-1668139"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,15]]},"references-count":0,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2019,1,17]]},"published-print":{"date-parts":[[2019,2]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0038-1668139","relation":{},"ISSN":["0939-7248","1439-359X"],"issn-type":[{"value":"0939-7248","type":"print"},{"value":"1439-359X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,15]]}}}