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Appendicitis in children.

T C Putnam1, N Gagliano, R W Emmens

  • 1Department of Surgery, University of Rochester, School of Medicine and Dentistry, New York.

Surgery, Gynecology & Obstetrics
|June 1, 1990
PubMed
Summary
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Comparing appendicitis therapy from 1972-1987 in children, this study found that routine antibiotic use for perforated appendicitis maintained low complication and zero mortality rates. Peritoneal lavage technique may influence complications.

Area of Science:

  • Pediatric Surgery
  • Infectious Diseases

Background:

  • Appendicitis is a common pediatric surgical emergency.
  • Previous studies established low complication and zero mortality rates for appendicitis treatment.
  • Therapeutic advancements aim to further reduce morbidity and mortality.

Purpose of the Study:

  • To evaluate if contemporary appendicitis treatment methods maintain low complication and zero mortality rates.
  • To compare outcomes between two distinct pediatric appendicitis treatment periods (1972-1982 vs. 1982-1987).
  • To identify potential factors influencing complication rates in pediatric appendicitis.

Main Methods:

  • Retrospective comparison of 406 children treated for appendicitis (1982-1987) against 657 children (1972-1982).
  • Analysis of complication rates (major and minor) and mortality.

Related Experiment Videos

  • Assessment of therapeutic interventions including antibiotic coverage and peritoneal lavage.

    • Main Results:

    • Routine antibiotic coverage for aerobic and anaerobic bacteria in perforated appendicitis yielded low complication rates: 3.2% major (e.g., obstruction, abscess) and 2.5% minor (e.g., wound infection, ileus).
    • These complication rates were comparable to the earlier study period.
    • The mortality rate remained zero in both study periods.
    • Complete peritoneal lavage in cases of generalized or extensive localized peritonitis was associated with subsequent small intestinal obstruction in four patients, a complication not observed in patients without lavage.

    Conclusions:

    • Contemporary appendicitis therapy, including routine antibiotic use, effectively maintains low complication and zero mortality rates in children.
    • The technique of peritoneal lavage, rather than the disease severity alone, may contribute to specific complications like small intestinal obstruction.
    • Continued vigilance in surgical technique is crucial for optimizing outcomes in pediatric appendicitis management.