Do patients with Down syndrome develop appendicitis?
OBJECTIVE
Given the number of individuals with Down syndrome (DS) and the high incidence of acute appendicitis (AA) in the general population, one would expect a certain number of patients with DS to develop AA. However, clinical experience suggests that AA is uncommon in patients with DS. This study was undertaken to determine whether the incidence of AA is significantly decreased in patients with DS.


METHODS
A 13-year cross-sectional study of the state's hospital discharge database was performed to estimate the annual incidence of AA in patients with DS and in the general population. Estimates were generated for both pediatric (0-17 years) and adult (≥ 18 years) populations and were compared using 95% confidence intervals (CIs). In addition, the authors' hospital database was queried over a 10-year time frame.


RESULTS
Incidence estimates of AA in children with DS and in the general pediatric population were 2.5 and 8.9 per 1000, respectively. In adults, the incidence estimates were 2.7 and 5.7 per 1000.


CONCLUSIONS
The incidence of AA is markedly lower in patients with DS than in the general population. Although the biological basis for this remains unknown, this information is relevant in the evaluation of the acute abdomen in patients with DS.
Division of Pediatric Surgery, Department of Pediatrics, Children's Hospital, Greenville Hospital System University Medical Center, Greenville, South Carolina 29605-4253, USA.
M Elizabeth N
ME
Lewis
Michael W L
MW
Gauderer
Dawn W
DW
Blackhurst
R Curtis
RC
Rogers
Wendy R
WR
Cornett
D000006:Abdomen, Acute / Q000175:diagnosis / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001064:Appendicitis / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004314:Down Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D013022:South Carolina / Q000453:epidemiology