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Carcinoid tumors, one of the most common malignant lesions involving the appendix, are typically found incidentally during routine appendectomies. While up to 20% of acute appendicitis cases present with perforation, the incidence of perforation among patients with undiagnosed carcinoid tumors of the appendix is unknown. In addition, there is no consensus on the management of carcinoid tumors in the perforated appendix or its impact on prognosis. We present a case of a 42-year-old woman presented with perforated appendicitis. Final pathology demonstrated the presence of a 1.1 cm, well-differentiated grade 1 neuroendocrine tumor at the tip of the appendix extending into the subserosa, without evidence for lymphovascular invasion. Given the depth of tumor invasion and the relatively young age of the patient, the decision was made to perform an interval completion right hemicolectomy for lymph node sampling. Only a few cases have been reported in the available literature, and it remains unclear whether appendiceal perforation represents an independent negative prognostic factor for patient survival. Additional data from cohort studies are needed to determine the true incidence, prognosis, and optimal management of newly diagnosed carcinoid tumors in the perforated appendix. Furthermore, clear consensus guidelines are needed to identify the subgroup of patients who would benefit from interval or primary right hemicolectomy. [ABSTRACT FROM AUTHOR]

Variation by sex in preoperative clinical characteristics of female and male laparoscopic Roux-en-Y gastric bypass (LRYGB) patients has not been evaluated comprehensively. The objective of our study was to identify clinical differences between morbidly obese women and men seeking LRYGB. Data from 83,059 patients in the Surgical Review Corporation's Bariatric Outcomes Longitudinal Database who were about to undergo LRYGB was analyzed in two groups: women (n = 65,325) and men (n = 17,734). Statistics were evaluated with analysis of variance and the χ2 equation. Cardiopulmonary comorbidities affected more men than women (P ≤ 0.0002) except for female asthma (P < 0.0001). Diabetes, gout, dyslipidemia, abdominal hernia, liver disease, alcohol and tobacco use, and substance abuse were higher for men (P < 0.0001). Women had gastroesophageal reflux disease, cholelithiasis, abdominal panniculitis, back pain, musculoskeletal pain, mental health disorders, depression, and impaired psychological status more often (P < 0.0001). Among LRYGB patients, men are older, smoke, and drink more, and have increased cardiopulmonary, metabolic, and liver disease versus women. Female somatic pain, gallstones, and mental health diagnoses are higher. This advance knowledge may aid management of LRYGB patients. By raising the index of suspicion for weight-related comorbidities, management of nonbariatric surgical patients may be facilitated. [ABSTRACT FROM AUTHOR]