Abstract
BackgroundIn children less than 3 years of age, there is little experience in the nonoperative management of appendiceal phlegmon or abscess (APA), especially in APA with an appendicolith. The purposes of this study were to evaluate the effects of an appendicolith and the success rate of nonoperative management for APA in these young children.MethodsChildren younger than 3 years of age with APA who underwent attempted initial nonoperative treatment between January 2008 and December 2016 were reviewed. Based on the presence or absence of an appendicolith on admission ultrasonography examination or computed tomography scan, children were divided into two groups: appendicolith group and no appendicolith group.ResultsThere were 50 children who met the study criteria. Among 50 children, three children failed to respond to nonoperative treatment because of aggravated intestinal obstruction or recurrent appendicitis within 30 days of admission. The overall success rate for nonoperative management of APA was 94% (47/50) in children younger than 3 years old. The rate of diarrhea and CRP levels were higher in the appendicolith group than that of the no appendicolith group (P < 0.05). However, the success rate and the hospital length of stay for nonoperative treatment in the appendicolith group and the no appendicolith group were similar without statistical significance.ConclusionAPA with or without an appendicolith can have nonoperative management without immediate appendectomy in children less than 3 years old.
Highlights
In children less than 3 years of age, there is little experience in the nonoperative management of appendiceal phlegmon or abscess (APA), especially in APA with an appendicolith
In young children less than 3 years of age, the incidence of appendicitis is low; appendicitis in this age group is missed by pediatricians [2]
If regression of appendiceal inflammation was noted on US or computed tomography (CT) and the children remained afebrile, physical signs improved, and the white blood cell (WBC) counts and C-reactive protein (CRP) levels decreased; the children were discharged home with oral broad-spectrum antibiotics such as cefdinir and cefaclor
Summary
In children less than 3 years of age, there is little experience in the nonoperative management of appendiceal phlegmon or abscess (APA), especially in APA with an appendicolith. The purposes of this study were to evaluate the effects of an appendicolith and the success rate of nonoperative management for APA in these young children. Acute appendicitis is the most common surgical emergency in children [1]. Zhang et al World Journal of Emergency Surgery (2018) 13:10 nonoperative treatment of APA during the first 3 years of life. The purposes of this retrospective study were to evaluate the appendicolith effects and the success rate of nonoperative management for APA in children under 3 years old
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