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Appendectomy in children with hypercalciuria/hyperuricosuria

Cesare Polito1, Antonio Marte, Angela La Manna

  • 1Third Pediatric Clinic, Department of Pediatrics, Second University of Naples, Naples, Italy. cesare.polito@golfonet.it

Journal of Pediatric Urology
|October 25, 2008
PubMed

Insights

Children with recurrent abdominal pains (RAPs) and hypercalciuria (HC) or hyperuricosuria (HU) undergo appendectomies more often. Many still experience RAPs post-surgery, suggesting HC/HU as a potential underlying cause.

Area of Science:

  • Pediatric Nephrology
  • Pediatric Urology
  • Gastroenterology

Background:

  • Recurrent abdominal pains (RAPs) are common in children, often leading to invasive procedures.
  • Idiopathic hypercalciuria (HC) and hyperuricosuria (HU) are metabolic conditions that can manifest with urinary symptoms.

Purpose of the Study:

  • To evaluate appendectomy rates in children with RAPs and HC/HU compared to controls.
  • To assess the persistence of RAPs and associated urinary symptoms after appendectomy in HC/HU patients.

Main Methods:

  • A consecutive case-control study involving 180 children with RAPs and HC/HU, and 270 controls.
  • Comparison of appendectomy rates and post-operative outcomes, including symptom persistence and urinalysis findings.

Main Results:

  • Appendectomy rates were significantly higher in HC/HU patients (10%) versus controls (1.5%).
  • RAPs persisted in 15 of 18 appendectomized HC/HU patients; 10 reported post-operative dysuria or hematuria.
  • Urinalysis was often negative for hematuria despite a history of urinary symptoms.

Conclusions:

  • The high appendectomy rate in children with RAPs and HC/HU may be linked to overlooked urological origins.
  • HC/HU should be considered in the differential diagnosis of RAPs in children, even without apparent urinary symptoms.

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