Early childhood appendicitis is still a difficult diagnosis.
We report on 90 pre-school children operated on for suspected acute appendicitis. The data analysis was retrospective. The outcome of exploration was negative in 54% (49/90) of cases; inflamed nonperforated appendix was removed 28% (25%/90) and a perforated appendix in 18% (16/90) of cases. In infants aged < 3 years (n = 26) the perforation rate was 60%, and in children age 4-5 years (n = 64) it was 27%. Tenderness in the iliac fossa, blood leukocytosis and urinanalysis had little diagnostic value. Preoperative signs of diffuse peritonitis and elevated values of serum C-reactive protein were found more frequently only in the children with a perforated appendix. There was no mortality and the postoperative morbidity varied between 10 and 20%. Thus, although appendectomy is currently a safe procedure in children, more specific non-invasive diagnostic acids are still needed to reduce the number of negative explorations and the rate of perforation.
Paajanen
H
H
Department of Pediatric Surgery, Tampere University Hospital, Finland.
Somppi
E
E
D000208:Acute Disease; D017677:Age Distribution; D001062:Appendectomy; D001064:Appendicitis / Q000175:diagnosis* / Q000601:surgery; D002097:C-Reactive Protein / Q000737:chemistry; D002675:Child, Preschool; D003951:Diagnostic Errors; D004630:Emergencies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007416:Intestinal Perforation / Q000175:diagnosis* / Q000601:surgery; D007958:Leukocyte Count; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
D002097:C-Reactive Protein