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Serum and peritoneal inflammatory mediators in children with suspected acute appendicitis

Ilan Dalal1, Eli Somekh, Avital Bilker-Reich

  • 1Pediatric Infectious/Allergy/Immunology Unit, The E. Wolfson Medical Center, Holon, Israel.

Archives of Surgery (Chicago, Ill. : 1960)
|February 23, 2005
PubMed

Insights

Inflammatory markers in peritoneal fluid, but not serum, can help diagnose appendicitis in children. However, systemic markers are not yet practical for differentiating appendicitis from other abdominal pain causes.

Area of Science:

  • Pediatric Surgery
  • Biochemistry
  • Immunology

Background:

  • Appendicitis is a common surgical emergency in children.
  • Accurate and timely diagnosis is crucial to prevent complications.
  • Systemic and local inflammatory markers are potential diagnostic tools.

Purpose of the Study:

  • To investigate differences in inflammatory markers between children with and without appendicitis.
  • To compare inflammatory marker levels in serum versus peritoneal fluid.
  • To assess the utility of these markers in identifying appendicitis and perforation.

Main Methods:

  • A cross-sectional study involving 24 children undergoing appendectomy.
  • Measured serum and peritoneal fluid levels of various cytokines and enzymes (IL-8, IL-10, G-CSF, etc.) using ELISA.
  • Compared marker concentrations between appendicitis patients (Group A) and controls (Group N), and between perforated and non-perforated cases.

Main Results:

  • Peritoneal fluid concentrations of IL-8, IL-10, MMP-9, and TIMP-1 were significantly higher in children with appendicitis compared to controls.
  • Peritoneal G-CSF was elevated in perforated appendicitis cases.
  • Serum TIMP-1 was also significantly higher in perforated appendicitis compared to controls, but not in appendicitis overall.

Conclusions:

  • Peritoneal inflammatory markers show promise in differentiating appendicitis in children.
  • Systemic inflammatory markers are currently insufficient for reliably diagnosing appendicitis in pediatric patients.
  • Further research may refine the use of specific markers for improved diagnostic accuracy.
Abstract

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