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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
Summary
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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