[Uncommon clinical aspects of appendicitis].
During the period between 1980-2000 at the authors department 5114 children with acute appendicitis were operated (on average 245 per year). From this period the year 1999 was selected when 160 children were operated on account of acute appendicitis. Thirty-eight children had an advanced finding--gangrenous appendicitis or an abscess. Gangrenous appendicitis or empyema of the appendix without perforation were recorded in 16 patients (10%), gangrenous appendicitis with perforation in 9 patients (5.6%), a periappendicular abscess in 13 (8.1%), phlegmonous appendicitis was recorded in 108 patients (67.5%) and in 14 patients the histological examination revealed mesenterial lymphadenitis (8.7%). The authors demonstrate on selected case-histories the problem of appendicitis not recognized in time and appendicitis with an atypical course. They draw attention to the uncommon clinical course in 5 patients where at first a tumour of the upper mediastinum, tumour of the abdominal cavity, twice diarrhoeal disease and a tumour in the lesser pelvis was suspected. The authors emphasize that even at a time when special examinations are available (ultrasonography, computed tomgraphy) it is important to make repeated clinical examinations of the patients at least in the course of three days.
Dusek
M
M
Klinika dĕtské chirurgie 2. LF UK a FN Motol, subkatedra dĕtské chirurgie IPVZ, Praha. michal.dusek@post.cz
Skába
R
R
Heroldová
D
D
Snajdauf
J
J
D000208:Acute Disease; D000293:Adolescent; D001064:Appendicitis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male