title: Intraluminal appendiceal fluid is a predictive factor for recurrent appendicitis after initial successful non-operative management of uncomplicated appendicitis in pediatric patients.
abstract: BACKGROUND
  The risk factors for recurrent appendicitis in pediatric patients are unclear. This study aimed to identify the predictive factors for recurrent appendicitis in pediatric patients who initially underwent successful non-operative management of uncomplicated appendicitis.
  
  
  METHODS
  Potential predictive factors for recurrent appendicitis in terms of clinical characteristics, laboratory data, and abdominal ultrasonography and computed tomography findings, were evaluated.
  
  
  RESULTS
  This study included 125 patients who underwent initial successful non-operative management of appendicitis. The rate of recurrent appendicitis was 19.2%, and the mean time to recurrence was 12.6 months. Univariate analyses found that rebound tenderness, muscle guarding, appendicoliths, appendiceal diameter >9 mm, and intraluminal appendiceal fluid were associated with recurrent appendicitis. Multivariate analysis identified only intraluminal appendiceal fluid as an independent predictor of recurrent appendicitis.
  
  
  CONCLUSIONS
  Intraluminal appendiceal fluid is a predictive factor for recurrent appendicitis after initial non-operative management. The results of this study provide valuable information that may help to determine the appropriate management during the first episode of appendicitis.
authors: Department of Pediatric Surgery, National Mie Hospital, Mie, Japan; Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan. Electronic address: koikyon@clin.medic.mie-u.ac.jp.
authors: Yuhki
authors: Y
authors: Koike
authors: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan.
authors: Keiichi
authors: K
authors: Uchida
authors: Department of Pediatric Surgery, National Mie Hospital, Mie, Japan.
authors: Kohei
authors: K
authors: Matsushita
authors: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan.
authors: Kohei
authors: K
authors: Otake
authors: Department of Pediatric Surgery, National Mie Hospital, Mie, Japan.
authors: Makoto
authors: M
authors: Nakazawa
authors: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan.
authors: Mikihiro
authors: M
authors: Inoue
authors: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan.
authors: Masato
authors: M
authors: Kusunoki
authors: Department of Pediatric Surgery, National Mie Hospital, Mie, Japan.
authors: Yoshihide
authors: Y
authors: Tsukamoto
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001062:Appendectomy; D001064:Appendicitis / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery; D001065:Appendix / Q000000981:diagnostic imaging; D001826:Body Fluids / Q000502:physiology*; D002438:Cefoperazone / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012008:Recurrence; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D000900:Anti-Bacterial Agents; D002438:Cefoperazone
keywords: Intraluminal appendiceal fluid; Pediatric; Predictive factor; Recurrent appendicitis