Frequency and outcome of complicated appendicitis in toddlers and preschoolers
Keywords:Acute appendicitis, Toddlers, Preschoolers, Perforated appendicitis, Complicated appendicitis
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.
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.
How to Cite
Copyright (c) 2020 Naseem Khan, Muhammad Ayub khan, Jehangir Khan; Sajjad Ali, Imran Khattak, Anwar Masood
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.