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Background: Appendicitis is one of the most common emergency abdominal operations in children. It is estimated that appendicitis is diagnosed in about 2 % of children who present to the emergency department because of acute abdominal pain1. Timely diagnosis and appendectomy can prevent abscess formation, and perforation as well as reduce early and late postoperative complications.

Methods: This study is a retrospective review of all children diagnosed with acute appendicitis in our emergency department between January 2015 – 2018. We have compared the clinical features and the results of examinations between two groups of patients - those who were diagnosed correctly and have been operated, on and those who were misdiagnosed and operated on later respectively more than 24 hours after initial control.

Results: This study includes fifty-nine children less than sixteen years old, admitted to our clinic and operated on due to acute appendicitis. Fifty-three (89.9%) of them were hospitalized after the first control, whereas the remaining six (10.1 %) were discharged home after the initial control. The misdiagnosed patients were returned to our department less than twenty hours after the first control. Compared with the patients in which the diagnosis was made correctly the misdiagnosed patients, in general, had lower levels of leukocytes, CRP, and temperature.

Conclusion: The diagnosis of appendicitis in children can be very difficult because of the atypical features. According to our experience and the data from other studies, still, there is not a single test or combination of clinical and laboratory examinations, able to discriminate between children with and without acute appendicitis with a high percentage of accuracy.

Keywords: Children, appendicitis, misdiagnosed

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Background: C-reactive protein (CRP) is one of the acute-phase proteins which increases during inflammatory conditions. Nowadays, C-reactive protein (CRP) is a commonly used biomarker, especially in the emergency departments (ED) for diagnostics of febrile and infectious patients. It is almost impossible to distinguish bacterial from nonbacterial (viral) infection by CRP level only -so the detailed history of onset of the disease is very important to establish the diagnosis of bacterial infection as a cause of acute abdominal pain.

Objective: The aim of this study was to establish the diagnostic value of leucocyte and CRP count in diagnosing acute abdominal pain.

Material and methods: We retrospectively evaluated 159 patients with acute abdominal pain admitted to the surgical department of the Clinical Hospital of Tetova and PHO “Alba –Med” over a period of 2 years respectively from January 20016 to January 2018. All patients included in this study were aged between five to 15 years old.

Results: During the study period there were158 patients (96 were females and 56 males). All the patients suffered from acute abdominal pain, whereas 45 of them had a surgical condition, respectively in 42 of them acute appendicitis as a cause of pain, Meckel’s diverticulitis, jejunal intussusception and ruptured ovarian cyst in three other patients.

In 105 patients’ nonsurgical condition was the reason for acute abdominal pain. CRP was performed within 24 h after admission in all the patients. In the group of patients with surgical disease 41 of them (91 %) had a value of CRP that was more than > 5g/L.

Conclusions: According to our experience we conclude that the CRP level is not sufficient to predict patients with acute abdominal pain that require surgical treatment.

Keywords: CRP, acute abdominal pain, surgery

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Introduction: Postsurgical gastro-intestinal or intestinal-intestinal anastomotic leaks while not frequent, are the most feared complications for any anastomoses performed in the gastrointestinal tract (GIT) by general surgeons. This is particularly important in the upper GIT, such as gastro-oesophageal anastomosis, where leaks can lead to severe sepsis and septic shock, need for re-operation, or stent placement. For this short review, we will address post-operative leaks following esophagectomy and sleeve gastrectomy as the most frequent bariatric procedure today. The factors and causes responsible for Upper Gastro-Intestinal Anastomosis, as they relate to the patient, surgeon or technique will be reviewed. Moreover, the diagnosis and current management will be examined.

Keywords: Esophago-gastrointestinal leaks, management of leaks, esophagectomy