PDF(Pubmed)
Abstract：
Appendicitis is one of the most common gastrointestinal conditions a person can develop. Throughout the years of assessing the different focuses of appendicitis, such as origin, symptoms, labs, diagnosis, treatment, and complications, there have been mere mentions of sex differences. One of the most known sex differences in appendicitis is the fact that males are significantly more likely to develop appendicitis compared to females. Another postulated difference is that males may be more likely to develop a perforated appendix. These differences significantly affect the various aspects of diagnosing and treating appendicitis and may even influence the outcome of appendicitis. Sex difference analysis of conditions has been widely researched over the last two decades, and sex can influence and impact conditions from initial presentation to the outcome of treatment. This paper evaluates the sex differences in appendicitis concerning incidence, risk factors, symptoms, diagnosis technique, treatment, and outcomes across ages. Following PRISMA guidelines, this systematic review reviewed PubMed, ScienceDirect, and ProQuest databases for articles pertaining to sex differences in appendicitis. The original article count was 21,121, which was narrowed down to 28 publications. It was found that, as previously described, males had a significantly higher rate of appendicitis, as well as were at significant risk of perforated appendicitis. No official risk factors were found to differ between the sexes, but males were more likely to complain of symptoms like right lower quadrant cramps/tenderness/pain and loss of appetite. Scores such as the pediatric appendicitis score (PAS) and Ohmann have been used to diagnose appendicitis, but the PAS was significantly more accurate for females, and the Ohmann resulted in significantly fewer negative appendectomies in females as well. Ultrasound and computed tomography (CT) are still the gold standards for diagnosis; however, while time to CT was significantly delayed in females, they were more likely to undergo extensive imaging, possibly to rule out other conditions. Males were more likely to undergo open appendectomies compared to females, who more frequently underwent laparoscopic appendectomy, yet females were more likely to experience complications. Further research should evaluate the influences that can predict postoperative outcomes following appendectomies between sexes and how to prevent/reduce their occurrence.
摘要：
阑尾炎是一个人可以发展的最常见的胃肠道疾病之一。多年来评估阑尾炎的不同重点，如起源,症状,labs,诊断,治疗,和并发症，只有提到性别差异。阑尾炎中最已知的性别差异之一是，与女性相比，男性更容易患阑尾炎。另一个假设的差异是，男性可能更容易出现穿孔阑尾。这些差异显着影响诊断和治疗阑尾炎的各个方面，甚至可能影响阑尾炎的结局。在过去的二十年中，条件的性别差异分析得到了广泛的研究，和性别可以影响和影响条件，从最初的表现到治疗的结果。本文评估了阑尾炎发病率的性别差异，危险因素，症状,诊断技术,治疗,以及不同年龄的结果。按照PRISMA准则,这篇系统的综述回顾了PubMed，ScienceDirect,和ProQuest数据库中有关阑尾炎性别差异的文章。原始文章数量为21,121，缩小到28种出版物。结果发现,如前所述，男性的阑尾炎发病率明显较高，以及穿孔性阑尾炎的显著风险。官方没有发现性别差异的危险因素，但是男性更容易抱怨右下腹痉挛/压痛/疼痛和食欲不振等症状。小儿阑尾炎评分（PAS）和Ohmann等评分已用于诊断阑尾炎，但是女性的PAS更准确，和Ohmann导致女性的阴性阑尾切除术也明显减少。超声和计算机断层扫描（CT）仍然是诊断的金标准；然而，而女性的CT时间明显延迟，他们更有可能接受广泛的成像，可能排除其他条件。与女性相比，男性更有可能接受开放性阑尾切除术，更经常接受腹腔镜阑尾切除术的人，然而，女性更容易出现并发症。进一步的研究应该评估可以预测性别间阑尾切除术后结果的影响，以及如何预防/减少其发生。
