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PEDIATRIC APPENDICITIS: AGE DOES MAKE A DIFFERENCE
Belén Aneiros1, Indalecio Cano1, Araceli García1
1Hospital 12 de Octubre, Madrid, Spain.
Insights
Appendicitis diagnosis and complications vary significantly by age in children. Younger children, especially those under five, face higher risks of misdiagnosis and poorer outcomes due to atypical symptoms.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Clinical Pediatrics
Background:
- Appendicitis is a common surgical emergency in children.
- Age-related differences in presentation and outcomes are not fully understood.
Purpose of the Study:
- To examine how patient age impacts appendicitis diagnosis and management.
- To assess complication rates across different pediatric age groups.
Main Methods:
- Retrospective analysis of 1,736 pediatric laparoscopic appendectomies (2000-2013).
- Patients stratified into age groups: infants, preschoolers, and children >5 and <5 years old.
- Statistical significance set at p < 0.05.
Main Results:
- Youngest patients exhibited more misdiagnoses and atypical appendicitis symptoms.
- Perforation rates were higher in children under five compared to those older than five (p<0.0001).
- Younger children experienced a higher incidence of postoperative complications (p=0.0002).
Conclusions:
- Age significantly influences appendicitis presentation and outcomes in children.
- Misdiagnosis in children under five, due to unusual symptoms, increases morbidity.
- While presentation differs, infants and preschoolers showed no significant difference in perforation or complication rates.
Objective:
To investigate the influence of patient age on the diagnosis and management of appendicitis, as well as to evaluate the rate of complications according to the age group.
Methods:
We undertook a retrospective analysis of 1,736 children who underwent laparoscopic appendectomy in our center between January 2000 and December 2013. Patients were divided in groups taken into account their age: group A were infants, group B were preschoolers, group C were those ones older than five years old, and group D were those ones younger than five years old. A p value of 0.05 was considered statistically significant.
Results:
We found higher incidence of misdiagnosis and atypical symptoms in the youngest patients. The rate of perforation was similar between group A and B (p=0.17). However, it was higher in group D than in group C (p<0.0001). The incidence of postoperative complications was higher in the youngest patients too (p=0.0002).
Conclusions:
The age does make a difference in acute appendicitis. Because of its unusual presentation in children younger than five years old, it is often misdiagnosed, which leads to an increased morbidity. Although clinical presentation varies between infants and preschoolers, no statistically significant differences were observed in the rate of perforated appendix or postoperative complications.
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