Abstract
Background: Acute appendicitis is a frequent indication of emergency abdominal surgery in the pediatric population. In younger children, especially toddlers, and preschoolers, the presentation is comparatively late resulting in complicated appendicitis. This study was done to determine the frequency and outcome of complicated appendicitis in toddlers and preschoolers. Methods: This is a cross-sectional study done at the Department of Pediatric Surgery, Lady Reading Hospital Peshawar, during August 2018 and February 2019. The medical records of 144 toddlers and preschoolers who presented with acute appendicitis were reviewed for demography, clinical presentation, operative findings, and outcome. Frequency and types of complicated appendicitis were recorded. Results: The mean age of study participants was 3 years (±2.84), including 46(32%) toddlers and 98(68%) preschoolers. Overall 62% of patients were male while 38% of patients were female. Complicated appendicitis was documented in 75% of patients. The common types of complicated appendicitis were perforation of the appendix with a localized abscess in 68 patients, gangrenous appendicitis in 4 patients, generalized peritonitis in 24 patients, and mass formation in 12 patients. All patients did well after surgery, except one who succumbed to complications of leukemia. Conclusion: In our study, a great deal (75%) of toddlers and preschoolers had complicated appendicitis especially perforated appendicitis with localized peritonitis.
Highlights
Acute appendicitis is a common surgical emergency and a frequent indication for abdominal surgery in the pediatric population.[1]
This study was planned to identify the frequency of complicated appendicitis in toddlers and preschoolers and their outcomes
The majority of the patients in our study had abdominal pain with or without localization, anorexia/reluctance to feed, increased/upper high limit of TLC, except one patient which was a known case of leukemia with pancytopenia
Summary
Acute appendicitis is a common surgical emergency and a frequent indication for abdominal surgery in the pediatric population.[1] Up to 8% of children with abdominal pain have acute appendicitis as its etiology.[2] in younger children, appendicitis is considered less common, but on the other hand, this age group is attributed to delayed presentation with multiple complications. The common complications reported in the literature are appendicitis with perforation resulting in localized or generalized peritonitis, appendicular abscess, or mass formation.[3] The rate of perforation has been reported to be as high as 82% in children younger than 5 years and almost 100% for 1-year-old.[4] This study was planned to identify the frequency of complicated appendicitis in toddlers and preschoolers and their outcomes. Especially toddlers, and preschoolers, the presentation is comparatively late resulting in complicated appendicitis. This study was done to determine the frequency and outcome of complicated appendicitis in toddlers and preschoolers
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