The Influence of the COVID-19 Pandemic on the Prevalence, Characteristics, Management, and Outcomes of Acute Appendicitis at the Academic Tertiary Center, Jeddah.

BACKGROUND: Acute appendicitis is the leading cause of acute abdominal pain that requires immediate intervention. Nonetheless, during COVID-19, hospital visits decreased as a result of serious COVID-19 concerns at that time, resulting in a decreased number of diagnosed cases with acute appendicitis due to COVID-19 restriction issues. OBJECTIVES: To report the percentage numbers, characteristics, applied management, and outcomes of patients with acute appendicitis during the COVID-19 pandemic and compare them to pre-COVID-19 cases. METHODS: A retrospective cohort study included all patients with acute appendicitis in the determined periods "pre-COVID-19" and "during COVID-19" at King Abdul-Aziz Medical City, Academic Tertiary Center, Jeddah, Saudi Arabia. Mean and standard deviation were used, while categorical data were reported as frequencies and percentages. Variables were analyzed by the Chi-squared test, Fisher's exact test, and Mann-Whitney test as appropriate. RESULTS: A total of 298 patients were included. The period of the pre-COVID-19 pandemic had 161 (54%) patients, while 137 (46%) were identified during COVID-19. The number of laparoscopic appendectomies performed during COVID-19 was less than the pre-COVID-19 pandemic of 96 cases (70.1%) vs 133 cases (82.6%) (P=0.0106). Uncomplicated appendicitis was the most commonly reported type of appendicitis in both periods: 113 (82.5%) during COVID-19 vs 135 (83.9%) pre-COVID-19, (P=0.7526). Furthermore, the number of patients who presented to the ER between 24 and 48 hours after the onset of symptoms was similar before and during the pandemic: 111 (68.9%) vs 89 (65%). CONCLUSION: Overall, we conclude that during the COVID-19 period, there was a reduction in the number of patients presenting with acute appendicitis and a lower chance of undergoing laparoscopic appendectomy due to COVID-19 restrictions. There was also an increase in perforated appendicitis and a decrease in gangrenous appendicitis.

Choroid Plexus Papilloma of the Fourth Ventricle in a Pediatric Patient: A Case Report.

Choroid plexus papilloma (CPP) is a rare intraventricular tumor. The common locations of the tumor vary based on the age of the patient. It usually occurs in the supratentorial region in children, however in adult patients, these tumors commonly present in the infratentorial region. We are presenting a rare case of a pediatric patient with a two month history of decreased activity and loss of interest in his surroundings and gait imbalance. He underwent a suboccipital craniotomy and excision of a CPP in the fourth ventricle. In conclusion, CCP should be considered as part of the differential diagnosis of intracranial tumors when the clinical presentation and investigations are suggestive regardless of the location to avoid misdiagnosing it when it occurs in an uncommon location.