title: Appendicitis in immunosuppressed children: Still a diagnostic and therapeutic dilemma?
abstract: Acute appendicitis in the immunosuppressed patients are often difficult to diagnose and are associated with increased morbidity and mortality. Recent debates on primary appendicitis and typhlitis-associated appendicitis have contributed to the diagnostic and therapeutic dilemma. We retrospectively reviewed all our immunosuppressed patients with appendicitis. The most frequent presenting symptom was fever followed by non-specific intermittent abdominal pain. The median delay in diagnosis was 4 days. CT scan was useful in making the diagnosis, but the presence of adjacent bowel thickening has contributed to the dilemma in diagnosis and treatment.
authors.affiliation: Department of Pediatric Surgery, KK Women's and Children's Hospital, Singapore, Singapore. chchui@surgeryforchildren.com
authors.forename: Chan-Hon
authors.initials: CH
authors.lastname: Chui
authors.forename: Mei-Yoke
authors.initials: MY
authors.lastname: Chan
authors.forename: Ah-Moy
authors.initials: AM
authors.lastname: Tan
authors.forename: Yee
authors.initials: Y
authors.lastname: Low
authors.forename: Te-Lu
authors.initials: TL
authors.lastname: Yap
authors.forename: Anette S
authors.initials: AS
authors.lastname: Jacobsen
mesh_terms: D000293:Adolescent; D001062:Appendectomy; D001064:Appendicitis / Q000175:diagnosis* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy; D008297:Male