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Pediatric appendicitis with appendicolith often presents with prolonged abdominal pain and a high risk of perforation

Hee Mang Yoon1, Jung Heon Kim2, Jong Seung Lee2

  • 1Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea.

World Journal of Pediatrics : WJP
|March 7, 2018
PubMed

Insights

Appendicoliths in children significantly increase the risk of severe appendicitis and perforation. Larger appendicoliths (≥5mm) and adjacent collapse are key indicators of perforation risk.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Radiology

Background:

  • Appendicoliths are a common cause of appendiceal obstruction and acute appendicitis.
  • Their presence is associated with a higher perforation rate in pediatric appendicitis cases.

Purpose of the Study:

  • To characterize appendicoliths in pediatric appendicitis.
  • To assess the clinical significance and risk factors associated with appendicoliths in children.

Main Methods:

  • Retrospective study of 269 pediatric patients (<17 years) with preoperative appendicitis diagnosis.
  • Analysis of clinical features and contrast-enhanced computed tomography (CECT) findings.

Main Results:

  • Appendicoliths were present in 54.6% of patients, with a mean diameter of 5.21 mm.
  • The appendicolith group showed prolonged pain, severe symptoms, and a significantly higher perforation rate (43.5% vs. 9.8%).
  • Maximal appendicolith diameter (≥5mm) and proximal collapse were significant risk factors for perforation.

Conclusions:

  • Pediatric appendicitis with appendicolith frequently presents with prolonged pain and severe symptoms.
  • Appendicoliths are a significant risk factor for perforation in pediatric appendicitis, with size and adjacent collapse being critical indicators.
Abstract

Keywords:
AppendicitisAppendicolithComputed tomographyPediatricsRisk factors

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