Frequency and outcome of complicated appendicitis in toddlers and preschoolers

Authors

  • Naseem Khan Department of Pediatric Surgery, Medical Teaching Institute, Lady Reading Hospital, Peshawar
  • Muhammad Ayub khan Department of Pediatric Surgery, Medical Teaching Institute, Lady Reading Hospital, Peshawar
  • Jehangir Khan Department of Pediatric Surgery, Medical Teaching Institute, Gajju Khan Medical College, Swabi
  • Sajjad Ali Department of Pediatric Surgery, Medical Teaching Institute, Khyber Teaching Hospital, Peshawar
  • Imran Khattak Department of Pediatric Surgery, Medical Teaching Institute, Lady Reading Hospital, Peshawar
  • Anwar Masood Department of Pediatric Surgery, Medical Teaching Institute, Lady Reading Hospital, Peshawar

DOI:

https://doi.org/10.46831/jpas.v1i1.5

Keywords:

Acute appendicitis, Toddlers, Preschoolers, Perforated appendicitis, Complicated appendicitis

Abstract

Background: Acute appendicitis is a frequent indication of emergency abdominal surgery in the pediatric population. In younger children, especially toddlers, and preschoolers, the presentation is comparatively late resulting in complicated appendicitis. This study was done to determine the frequency and outcome of complicated appendicitis in toddlers and preschoolers.

Methods: This is a cross-sectional study done at the Department of Pediatric Surgery, Lady Reading Hospital Peshawar, during August 2018 and February 2019. The medical records of 144 toddlers and preschoolers who presented with acute appendicitis were reviewed for demography, clinical presentation, operative findings, and outcome. Frequency and types of complicated appendicitis were recorded.

Results: The mean age of study participants was 3 years (±2.84), including 46(32%) toddlers and 98(68%) preschoolers. Overall 62% of patients were male while 38% of patients were female. Complicated appendicitis was documented in 75% of patients. The common types of complicated appendicitis were perforation of the appendix with a localized abscess in 68 patients, gangrenous appendicitis in 4 patients, generalized peritonitis in 24 patients, and mass formation in 12 patients. All patients did well after surgery, except one who succumbed to complications of leukemia.

Conclusion: In our study, a great deal (75%) of toddlers and preschoolers had complicated appendicitis especially perforated appendicitis with localized peritonitis.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Author Biography

Naseem Khan, Department of Pediatric Surgery, Medical Teaching Institute, Lady Reading Hospital, Peshawar

Resident

References

Hall MJ, DeFrances CJ, Williams SN, Golosinskiy A, Schwartzman A. National hospital discharge survey: 2007 summary: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statis-tics; 2010. Available from: https://books.google.com.pk/books?id=R0eRIEq0ad0C&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false

Almström M, Svensson JF, Patkova B, Sven-ningsson A, Wester T. In-hospital surgical delay does not increase the risk for perforated appen-dicitis in children: a single-center retrospective cohort study. An Surg. 2017; 265:616-21.

Almaramhy HH. Acute appendicitis in young children less than 5 years: review article. Italian J Ped. 2017; 43:15.

Singh M, Kadian YS, Rattan KN, Jangra B. Com-plicated appendicitis: analysis of risk factors in children. African J Paed Surg. 2014; 11:109.

Marzuillo P, Germani C, Krauss BS, Barbi E. Appendicitis in children less than five years old: a challenge for the general practitioner. World J Clin Pediatr. 2015; 4:19.

Nance ML, Adamson WT, Hedrick HL. Appendi-citis in the young child: a continuing diagnostic challenge. Pediatr Emerg Care. 2000; 16:160-2.

Minneci PC, Mahida JB, Lodwick DL, Sulkowski JP, Nacion KM, Cooper JN, et al. Effectiveness of patient choice in nonoperative vs surgical man-agement of pediatric uncomplicated acute ap-pendicitis. JAMA Surg. 2016; 151:408-15.

Mallick MS. Appendicitis in pre-school children: A continuing clinical challenge. A retrospective study. Inter J Surg. 2008; 6:371-3.

Amin P, Cheng D. Management of complicated appendicitis in the pediatric population: when surgery doesn't cut it. Semin Intervent Radiol. 2012; 29: 231-6.

Asad S, Ahmed A, Ahmad S, Ali S, Ahmed S, Ghaffar S, et al. Causes of delayed presentation of acute appendicitis and its impact on morbidity and mortality. J Ayub Med Coll Abbottabad. 2015; 27:620–3.

Published

2020-07-13

How to Cite

1.
Khan N, khan MA, Khan J, Ali S, Khattak I, Masood A. Frequency and outcome of complicated appendicitis in toddlers and preschoolers. J Pediatr Adolesc Surg [Internet]. 2020Jul.13 [cited 2020Oct.28];1(1):41-3. Available from: http://jpedas.org/ojs/index.php/jpedas/article/view/5
Share |