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Appendicitis in children: a continuing clinical challenge.

R R Marrero1, S Barnwell, E L Hoover

  • 1Department of Surgery, Meharry Medical College, Nashville, Tennessee.

Journal of the National Medical Association
|October 11, 1992
PubMed
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Appendicitis presentation in children remained consistent over a decade. Perforation rates did not significantly decrease with age, and diagnosis-related groups (DRGs) slightly increased hospital stays.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology

Background:

  • Appendicitis is a common surgical emergency in children.
  • Understanding presentation patterns and outcomes is crucial for timely diagnosis and treatment.

Purpose of the Study:

  • To analyze trends in appendicitis presentation in pre-adolescent children over a 10-year period.
  • To investigate the relationship between age and perforation incidence.
  • To assess the impact of diagnosis-related groups (DRGs) on hospital length of stay.

Main Methods:

  • Retrospective chart review of 42 children under 12 diagnosed with acute appendicitis between 1980-1989.
  • Analysis of clinical presentation, laboratory findings, surgical outcomes, and length of stay.
  • Comparison of pre- and post-DRG implementation data.

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Main Results:

  • Consistent presentation patterns including right lower quadrant pain, guarding, and positive diagnostic signs were observed.
  • A significant perforation rate of 36% was found, with no clear decrease related to age.
  • The average postoperative length of stay increased slightly after the implementation of DRGs.

Conclusions:

  • Appendicitis presentation in children under 12 remained consistent over the study period.
  • Age did not appear to be a significant factor in reducing perforation rates.
  • Diagnosis-related groups (DRGs) may have contributed to a slight increase in hospital length of stay.