[Appendicitis in children: clinical observation in 88 surgical cases]

From February 1983 to December 1987, appendectomy was done in 106 children for the presumptive diagnosis of appendicitis with or without perforation at VGH-Taichung. Subsequent pathological findings confirmed suppurative appendicitis in 53 patients (48.1%), and perforated appendicitis in 37 patients (34.9%). There were 18 (17.0%) normal appendices. The age of patients ranged from 2 to 14 years, with an average of 8.9 years. Only 9.1% of the patients were under 5 years of age. The perforation rate was 62.5% in children under 5 years of age, and 59.4% in children 5 to 8 years old, both of them had a higher incidence than children over 8 years of age (27.1%, P less than 0.05). The mean duration of symptoms was 76.2 hours in children with perforated appendicitis, which was significantly longer than that in children with suppurative appendicitis (28.7 hrs, P less than 0.05). The use of triple combination of antibiotics in the treatment of perforated appendicitis has been proved to significantly decrease the incidence of postoperative wound complications. Early diagnosis, prompt surgical intervention, and recognition and treatment of residual septic foci were proved appropriate means of treatment of appendicitis.