Clinical profile and risk factors for perforation of acute appendicitis in children

Abstract

To describe the clinical profile and determine the risk factors associated with perforation of appendix in children under 13 years of age. A retrospective review of charts of children admitted for appendicitis between the year 1999 to 2000. Department of Paediatrics and Child Health, Tikur Anbessa Specialised Hospital, Addis Ababa University, Addis Ababa, Ethiopia. A total of 147 children under the age of 13 years admitted for acute appendicitis. A total of 147 cases were analysed. The mean age was 9.3 years and appendicitis occurred more commonly among males. Factors independently found to be predictors of perforation by univariate analysis were: age <10 years, duration of illness for over 24 hours, history of treatment elsewhere before arrival to TAH, generalised abdominal tenderness, rebound tenderness and/or rigidity, hypoactive and/or absent bowel sound, RLQ mass, leukocytosis with neutrophilia and presence of complications. However, none of these was retained as significant factors in the multiple logistic regression analysis. There are many factors that are associated with perforation but there is no single factor that independently predicted perforation of appendicitis. Delay in intervention due to late presentation to hospital is an important preventable factor.