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Related Experiment Videos

Routine interval appendectomy in children is not indicated.

Devin Puapong1, Steven L Lee, Philip I Haigh

  • 1Division of Pediatric Surgery and Department of Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA 90027, USA.

Journal of Pediatric Surgery
|September 13, 2007
PubMed
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Recurrent appendicitis is rare in children after nonoperative management of perforated appendicitis. Interval appendectomy (IA) is not always necessary for these pediatric patients, simplifying treatment.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Infectious Diseases

Background:

  • Evaluating outcomes for children treated without interval appendectomy (IA) after nonoperative management of perforated appendicitis.
  • Assessing the necessity of IA in pediatric perforated appendicitis cases.

Purpose of the Study:

  • To determine the rate of recurrent appendicitis in children managed nonoperatively without IA.
  • To compare cumulative hospital stay for different management strategies.

Main Methods:

  • Retrospective study of pediatric appendicitis patients (1992-2004) across 12 hospitals.
  • Mean follow-up of 7.5 years.
  • Outcomes analyzed: recurrent appendicitis and cumulative hospital stay.

Main Results:

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  • 6439 patients included; 72 managed nonoperatively.
  • 5 (8%) of 61 patients without IA developed recurrent appendicitis.
  • Cumulative hospital stay: 6.6 days (no IA), 8.5 days (IA), 9.6 days (recurrent appendicitis).

Conclusions:

  • Recurrent appendicitis is uncommon after successful nonoperative management of perforated appendicitis in children.
  • Routine interval appendectomy (IA) may not be indicated for all pediatric patients.
  • Nonoperative management followed by observation appears safe and effective.