Perforated Appendicitis in Children
DOI:
https://doi.org/10.53555/ans.v7i1.1504Keywords:
Perforated appendicitis, peritoneal cavity, appendectomy, controversial.Abstract
Perforation of appendix is common in children, many aspects of the management of perforated appendicitis in children remain controversial. Prospective study 86 cases of appendicular perforation in children were carried out from Jan.2019 to Feb.2020 in Nangarhar regional hospital, pediatric surgery department. Total of 86 children, 34 females and 52 males diagnosed as a perforated appendicitis were studied prospectively. 43 patients were included randomly in both the group, group-1(early appendectomy after 24hours of diagnosis) and group-2 (Interval appendectomy after 6 to 8 week from diagnosis). The maximum number of patients 55.81% was found in the age group of 11 to 14 years. Intraoperative position of appendix was retrocecal in 36(41.86%) patients, followed by pelvic in 40(46.51%) patients. The maximum overall adverse effects was observed in group-2 than group-1 patients. overall postoperative scar was better in all patients of group-1 than group-2 patients. Hospital stay was below 4 days in 34(79.07%) patients of group-1and in 16(37.20%) patients of group-2. Minimal morbidity with no mortality were observed in present series and 4 (4.65%) patients were lost to follow up ingroup-2. The overall adverse event rate after early appendectomy was significantly lower than that after interval appendectomy. Early appendectomy for perforated appendicitis in children significantly reduced the time away from normal activities, overall adverse event rate, hospital cost and charges.
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[2]. Lintula H, Kokki H, Vanamo K et al (2002) Laparoscopy in Children With Complicated Appendicitis. J Pediatr Surg 37(9):13171320.
[3]. Garneski S (2012) Surgical Treatment Can Cut Costs and Improve Outcomes for Children with Perforated Appendicitis. News from the J. of American College of Surgeon. Online April 2, 2012.
[4]. Rappaport WD, Peterson M, Stanton C (1989) Factors responsible for the high perforation rate seen in early childhood appendicitis. Am.J.Surg. 55; 602-6.
[5]. Guthery SL, Hutchings C, Dean JM et al (2004). National estimates of hospital utilization by children with gastrointestinal disorders: analysis of the 1997 kids’ inpatient database. J Pediatr. 144(5):589-594.
[6]. Kuhls TL (1998) Appendicitis and pelvic Abscess T.B. of pediatric, Infectious Disease section eight, 4th edition, By Ralph D.Feifin&Dames D.Cherry.1; 662-667.
[7]. Klein Joel (2009) Appendicitis. http://kidshealth.org/parent/misc/reviewers.html
[8]. Williams N and Kapila L (1994) Acute appendicitis in the under 5 yrs old child. JR Coll Surgery Edinb. 39; 168-170.
[9]. Andeson KD, Parry RL (1998) Childhood appendicitis: T.B. Pediatric Surgery, 5th edition. 2; 1369-1378.
[10]. Hung MH, Lin LH. Chen DF et al (2012) Clinical Manifestations in Children with Ruptured Appendicitis. Pediatric Emergency Care: 28 (5): 433–435.
[11]. Williams N and Bello M (1998) Perforation rate relates to delayed Presentation in childhood acute appendicitis. JR Coll Surgery Edinb. 4(2); 101-2.
[12]. Gamal Reda and Moove TC (1990) Appendicitis in children aged 13 years and younger. The American J. of Surgery.159; 589-591. [13]. Lessin MS, Chan M, Catallozzim ET al (1999) Selective use of USG for acute appendicitis in children. AJS. 177; 193-196.
[14]. Khalili TM, Hiatt JR, Savar A et al (1999) Perforated appendicitis is not a contraindication to laparoscopy. Am Surg. 65(10):965-7.
[15]. Cheng CD, Lin LH, Chen DF (2010) Ruptured Appendicitis in a Two-Year-Old Child: A Case Report. Fu-Jen Journal of Medicine. 8(2): 97-103.
[16]. Blakely ML, Williams R, Dassinger MS (2011) Early vs. interval appendectomy for children with perforated appendicitis. Arch Surg. 146(6):660-5.
[17]. Nadler EP, Reblock KK, Qureshi FG et al (2006) Laparoscopic appendectomy in children with perforated appendicitis. J Laparoendosc Adv Surg Tech A.16 (2):159-63.
[18]. Georges A, Adnan S, Spencer B et al (2004) The Complication Rate and Outcomes of Laparoscopic Appendicectomy in Children with Perforated Appendicitis. Pediatric Endosurgery & Innovative Techniques.8 (1): 203-208.
[19]. Williams RF, Blakely ML, Fischer PE et al (2009) Diagnosing Ruptured Appendicitis Preoperatively in Pediatric Patients.J Am Coll Surg. 208:819–828.
[20]. Blakely M, Monroe C (2012) Removing ruptured appendix sooner lowers hospital cost, charges. Journal of American College of Surgeons. Http://www.news medical.net.
[21]. Dolgin S (2011) Children with perforated appendicitis may benefit from early surgical intervention. Archives of surgery.3: 105-109.
[22]. Neilson IT et al (1990) Appendicitis in children: current therapeutic recommendation.J.Pediatr. Surg. 25; 1113.
[23]. Myers AL, Williams RF, Giles K, et al (2012) Hospital cost analysis of a prospective, randomized trial of early vs. interval appendectomy for perforated appendicitis in children. J Am Coll Surg. 214(4):427– 434.
[24]. Ein SH, Langera JC, Danemanb A (2005) Nonoperative management of pediatric ruptured appendix with inflammatory mass or abscess: presence of an appendicolith predicts recurrent appendicitis. Journal of Pediatric Surgery. 40: 1612– 1615.
[25]. Fishman SJ, Pelosi L, Susan L ET al (2000) Perforated appendicitis: Prospective outcome analysis for 150 children. J. Pediatric
Surgery. 35(6); 923-926.
[26]. Kokoska ER, Silen ML, Tracy TF et al (1998) Perforated appendicitis in children: risk factors for the development of complications. Surgery. 124(4):619-25.
[27]. Mosdell DM, Morris DM, Fry DE (1994) Peritoneal culture and antibiotic therapy in pediatric perforated appendicitis; Am J. Surgery. 167; 313-316.
[28]. Marchildon MB, Dudgeon DL (1977) Perforated appendicitis: current experience in a childrens hospital.
[29]. Ann.J.Surg. 185; 84-7.
[30]. David IB, Buck JR, Filler RM (1982) Rational use of antibiotics for perforated appendicitis in children. J.Pediatr.Surg. 17: 494-98.
[31]. Schwartz MZ, Tapper D, Solenberger RI (1983) Management of perforated appendicitis in children. The controversy continues. Annals Surgery.197:407-411.
[32]. Karp MP (1986) The avoidable excess in the management of perforated appendicitis in children. J.Pediatr.Surg. 21: 508.
[33]. Samelson SL, Reyes HM (1987) Management of perforated appendicitis in children.Revisited, 122(6):691-696.
[34]. Elmore JR, Dibbins AW, Curci MR (1987) The treatment of complicated appendicitis in children.Arch.Surg.122:424-7.
[35]. Stone HH, Sanders SL, Martin JD (1971) Perforated appendicitis in children.Surgery.69:673-9.
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