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Appendiceal perforation in children diagnosed in a pediatric emergency department

D S Nelson1, B Bateman, R G Bolte

  • 1Primary Children's Medical Center, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City 84113, USA. doug.nelson@hsc.utah.edu

Pediatric Emergency Care
|August 31, 2000
PubMed

Insights

Appendiceal perforation (AP) affects nearly half of pediatric acute appendicitis (AA) cases. Younger children with symptoms like vomiting and fever are at higher risk for AP, necessitating earlier diagnosis and treatment.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Emergency Medicine

Background:

  • Acute appendicitis (AA) is a common surgical emergency in children.
  • Appendiceal perforation (AP) is a significant complication of AA, leading to increased morbidity.
  • Understanding factors associated with AP is crucial for timely intervention.

Purpose of the Study:

  • To determine the incidence of appendiceal perforation (AP) in children diagnosed with acute appendicitis (AA).
  • To identify clinical and demographic factors associated with AP in pediatric patients.

Main Methods:

  • Retrospective chart review of 131 children under 17 years old diagnosed with AA.
  • Data collected from the Emergency Department (ED) of Primary Children's Medical Center (PCMC).
  • Analysis of patient demographics, symptom duration, physical findings, and laboratory results.

Main Results:

  • The overall incidence of AP was 47%.
  • Patients with AP were younger (median age 8.0 vs 11.0 years) and had longer illness duration (3.0 vs 1.4 days).
  • Vomiting, fever, higher temperatures, and elevated leukocyte band forms were associated with AP.

Conclusions:

  • Younger age, prolonged illness, vomiting, and fever are risk factors for AP in children with AA.
  • Unexpectedly, higher total white blood cell counts and delayed diagnosis did not correlate with AP.
  • Increased physician awareness and prompt referral are recommended to reduce AP rates.
Abstract

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