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[The treatment of appendicular peritonitis in children]

A G Momotov, S K Pridat'ko, G A Litvinov

    Klinichna Khirurhiia
    |May 20, 1999
    PubMed

    Insights

    Guided laparostomy in critically ill children with appendicitis and peritonitis reduced complications and mortality. This surgical approach, combined with specific interventions, improved patient outcomes in severe cases.

    Area of Science:

    • Pediatric Surgery
    • Critical Care Medicine
    • Gastrointestinal Surgery

    Background:

    • Acute destructive appendicitis complicated by peritonitis poses a significant threat to pediatric patients.
    • Effective management strategies are crucial for improving survival rates and reducing morbidity in these critically ill children.

    Observation:

    • A study involving 513 children with acute destructive appendicitis and peritonitis evaluated the impact of guided laparostomy.
    • In extremely severe cases (11 patients), laparostomy with a double bottom was performed, resulting in 8 recoveries and 3 deaths.
    • Complications included intestinal eventration (2 patients) and postoperative infiltrate (5 patients).

    Findings:

    • Guided laparostomy in terminal patients significantly lowered the incidence of postoperative complications and mortality.
    • The application of prolonged novocainic block of the terminal ileum mesentery and ileocecal valve via Seldinger technique was utilized for treatment.

    Implications:

    • Guided laparostomy represents a potentially life-saving intervention for pediatric patients with complicated appendicitis.
    • Further research into optimizing surgical techniques and adjunctive therapies like regional blocks may enhance outcomes in severe peritonitis.
    • This approach offers a pathway to improved survival and reduced long-term complications in pediatric surgical emergencies.

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