Prevalence of perforated appendicitis and its determinants in pediatric appendicitis patients admitted in tertiary care centre, South India: a cross sectional study

Abstract

Background: Appendicitis remains a common indication for urgent surgical intervention in pediatric age group. Acute appendicitis has the highest incidence during the second decade of life. When the diagnosis is performed, perforation could be already present in 30%-75% of children, with young children being at higher risk. The challenge for the practitioner is to perform a timely diagnosis of acute appendicitis in first years of life before complications occur.Methods: A facility based cross sectional study was conducted with sample size of 108. The patients diagnosed and operated for acute appendicitis using Alvarado score were correlated with intra operative findings.Results: Total 108 patients with median age of 11 (IQR 9–13) years, were included in the study in which 66% were male. Overall 18% (95% CI 11%-25%) had perforated appendix and 5% (95% CI 2%-11%) had appendicitis with abscess. Male gender, patients presenting with fever, guarding, rigidity and patients presenting 48 hours after developing symptoms, had higher chance of perforation. Mean count of WBC (17000 v/s 11000) and neutrophils (75% v/s 68%) were found to be higher in patients with perforated appendicitis.Conclusions: One-fifth of the pediatric appendicitis patients presenting in tertiary care patients had perforated appendicitis.