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Published in: BMC Gastroenterology 1/2012

Open Access 01-12-2012 | Study protocol

The value of pancreatic stone protein in predicting acute appendicitis in patients presenting at the emergency department with abdominal pain

Authors: Christoph Tschuor, Dimitri Aristotle Raptis, Përparim Limani, Thomas Bächler, Christian Eugen Oberkofler, Stefan Breitenstein, Rolf Graf

Published in: BMC Gastroenterology | Issue 1/2012

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Abstract

Background

Pancreatic Stone Protein (PSP) is a protein naturally produced mainly in the pancreas and the gut. There is evidence from experimental and clinical trials that blood PSP levels rise in the presence of inflammation or infection. However, it is not known whether PSP is superior to other established blood tests (e.g. White Blood Count, Neutrophils or C - reactive protein) in predicting appendicitis in patients presenting with abdominal pain and a clinical suspicion of appendicitis at the emergency room.

Methods/design

The PSP Appendix Trial is a prospective, multi-center, cohort study to assess the value of PSP in the diagnostic workup of acute appendicitis. 245 patients will be prospectively recruited. Interim analysis will be performed once 123 patients are recruited. The primary endpoint of the study concerns the diagnostic accuracy of PSP in predicting acute appendicitis and therefore the evidence of appendicitis on the histopathological specimen after appendectomy.

Discussion

The PSP Appendix Trial is a prospective, multi-center, cohort study to assess the value of PSP in the diagnostic workup of acute appendicitis.

Trial registration

ClinicalTrials.gov: NCT01610193; Institution Ethical Board Approval ID: KEKZH- Nr. 2011–0501
Appendix
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Literature
2.
go back to reference Karamanakos SN, Sdralis E, Panagiotopoulos S, Kehagias I: Laparoscopy in the emergency setting: a retrospective review of 540 patients with acute abdominal pain. Surg Laparosc Endosc Percutan Tech. 2010, 20 (2): 119-124. 10.1097/SLE.0b013e3181d87178.CrossRefPubMed Karamanakos SN, Sdralis E, Panagiotopoulos S, Kehagias I: Laparoscopy in the emergency setting: a retrospective review of 540 patients with acute abdominal pain. Surg Laparosc Endosc Percutan Tech. 2010, 20 (2): 119-124. 10.1097/SLE.0b013e3181d87178.CrossRefPubMed
3.
go back to reference Hansson J, Körner U, Ludwigs K, Johnsson E, Jönsson C, Lundholm K: Antibiotics as First-line Therapy for Acute Appendicitis: Evidence for a Change in Clinical Practice. World J Surg. 2012, 36 (9): 2028-2036. 10.1007/s00268-012-1641-x.CrossRefPubMed Hansson J, Körner U, Ludwigs K, Johnsson E, Jönsson C, Lundholm K: Antibiotics as First-line Therapy for Acute Appendicitis: Evidence for a Change in Clinical Practice. World J Surg. 2012, 36 (9): 2028-2036. 10.1007/s00268-012-1641-x.CrossRefPubMed
4.
go back to reference Niwa H, Hiramatsu T: A rare presentation of appendiceal diverticulitis associated with pelvic pseudocyst. World J Gastroenterol. 2008, 14 (8): 1293-1295. 10.3748/wjg.14.1293.CrossRefPubMedPubMedCentral Niwa H, Hiramatsu T: A rare presentation of appendiceal diverticulitis associated with pelvic pseudocyst. World J Gastroenterol. 2008, 14 (8): 1293-1295. 10.3748/wjg.14.1293.CrossRefPubMedPubMedCentral
5.
go back to reference Howell JM, Eddy OL, Lukens TW, Thiessen ME, Weingart SD, Decker WW: Clinical policy: critical issues in the evaluation and management of emergency department patients with suspected appendicitis. Ann Emerg Med. 2010, 55 (1): 71-116. 10.1016/j.annemergmed.2009.10.004.CrossRefPubMed Howell JM, Eddy OL, Lukens TW, Thiessen ME, Weingart SD, Decker WW: Clinical policy: critical issues in the evaluation and management of emergency department patients with suspected appendicitis. Ann Emerg Med. 2010, 55 (1): 71-116. 10.1016/j.annemergmed.2009.10.004.CrossRefPubMed
6.
go back to reference Yeh B: Evidence-based emergency medicine/rational clinical examination abstract. Does this adult patient have appendicitis?. Ann Emerg Med. 2008, 52 (3): 301-303. 10.1016/j.annemergmed.2007.10.023.CrossRefPubMed Yeh B: Evidence-based emergency medicine/rational clinical examination abstract. Does this adult patient have appendicitis?. Ann Emerg Med. 2008, 52 (3): 301-303. 10.1016/j.annemergmed.2007.10.023.CrossRefPubMed
7.
go back to reference Place RC: Acute urinary retention in a 9-year-old child: an atypical presentation of acute appendicitis. J Emerg Med. 2006, 31 (2): 173-175. 10.1016/j.jemermed.2005.10.002.CrossRefPubMed Place RC: Acute urinary retention in a 9-year-old child: an atypical presentation of acute appendicitis. J Emerg Med. 2006, 31 (2): 173-175. 10.1016/j.jemermed.2005.10.002.CrossRefPubMed
8.
go back to reference Keel M, Härter L, Reding T, Sun LK, Hersberger M, Seifert B, Bimmler D, Graf R: Pancreatic stone protein is highly increased during posttraumatic sepsis and activates neutrophil granulocytes. Crit Care Med. 2009, 37 (5): 1642-1648. 10.1097/CCM.0b013e31819da7d6.CrossRefPubMed Keel M, Härter L, Reding T, Sun LK, Hersberger M, Seifert B, Bimmler D, Graf R: Pancreatic stone protein is highly increased during posttraumatic sepsis and activates neutrophil granulocytes. Crit Care Med. 2009, 37 (5): 1642-1648. 10.1097/CCM.0b013e31819da7d6.CrossRefPubMed
9.
go back to reference Boeck L, Graf R, Eggimann P, Pargger H, Raptis DA, Smyrnios N, Thakkar N, Siegemund M, Rakic J, Tamm M, Stolz D: Pancreatic stone protein: a marker of organ failure and outcome in ventilator-associated pneumonia. Chest. 2011, 140 (4): 925-932. 10.1378/chest.11-0018.CrossRefPubMed Boeck L, Graf R, Eggimann P, Pargger H, Raptis DA, Smyrnios N, Thakkar N, Siegemund M, Rakic J, Tamm M, Stolz D: Pancreatic stone protein: a marker of organ failure and outcome in ventilator-associated pneumonia. Chest. 2011, 140 (4): 925-932. 10.1378/chest.11-0018.CrossRefPubMed
10.
go back to reference Alvarado A: A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986, 15: 557-564. 10.1016/S0196-0644(86)80993-3.CrossRefPubMed Alvarado A: A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986, 15: 557-564. 10.1016/S0196-0644(86)80993-3.CrossRefPubMed
11.
go back to reference Dindo D, Demartines N, Clavien PA: Classification of Surgical Complications A New Proposal With Evaluation in a Cohort of 6336 Patients and Results of a Survey. Ann Surg. 2004, 240 (2): 205-213. 10.1097/01.sla.0000133083.54934.ae.CrossRefPubMedPubMedCentral Dindo D, Demartines N, Clavien PA: Classification of Surgical Complications A New Proposal With Evaluation in a Cohort of 6336 Patients and Results of a Survey. Ann Surg. 2004, 240 (2): 205-213. 10.1097/01.sla.0000133083.54934.ae.CrossRefPubMedPubMedCentral
12.
go back to reference Raptis DA, Mettler T, Schadde E, Fischer MA, Patak M, Lesurtel M, El-Badry AM, Eshmuminov D, Oberkofler CE, Melloul E, Clavien PA, Breitenstein S: Development of a novel open source web-based multi-centre clinical trial management system, Proceedings of the Fifteenth International Symposium for Health Information Management Research. 2011, 449-457. Raptis DA, Mettler T, Schadde E, Fischer MA, Patak M, Lesurtel M, El-Badry AM, Eshmuminov D, Oberkofler CE, Melloul E, Clavien PA, Breitenstein S: Development of a novel open source web-based multi-centre clinical trial management system, Proceedings of the Fifteenth International Symposium for Health Information Management Research. 2011, 449-457.
13.
go back to reference National Guideline Clearinghouse (NGC): Guideline summary: Clinical policy: critical issues in the evaluation and management of emergency department patients with suspected appendicitis. Rockville (MD): National Guideline Clearinghouse (NGC), http://www.guideline.gov, National Guideline Clearinghouse (NGC): Guideline summary: Clinical policy: critical issues in the evaluation and management of emergency department patients with suspected appendicitis. Rockville (MD): National Guideline Clearinghouse (NGC), http://​www.​guideline.​gov,
14.
go back to reference Sedlak M, Wagner OJ, Wild B, Papagrigoriades S, Exadaktylos AK: Is there still a role for rectal examination in suspected appendicitis in adults?. Am J Emerg Med. 2008, 26 (3): 359-360. 10.1016/j.ajem.2007.06.006.CrossRefPubMed Sedlak M, Wagner OJ, Wild B, Papagrigoriades S, Exadaktylos AK: Is there still a role for rectal examination in suspected appendicitis in adults?. Am J Emerg Med. 2008, 26 (3): 359-360. 10.1016/j.ajem.2007.06.006.CrossRefPubMed
Metadata
Title
The value of pancreatic stone protein in predicting acute appendicitis in patients presenting at the emergency department with abdominal pain
Authors
Christoph Tschuor
Dimitri Aristotle Raptis
Përparim Limani
Thomas Bächler
Christian Eugen Oberkofler
Stefan Breitenstein
Rolf Graf
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2012
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/1471-230X-12-154

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