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Acute appendicitis in children.

W Y Lau1, S T Fan, W C Yip

  • 1Government Surgical Unit, Queen Mary Hospital, Hong Kong.

The Australian and New Zealand Journal of Surgery
|December 1, 1987
PubMed
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Delayed diagnosis of acute appendicitis in children increases complications. Early recognition by parents and doctors is crucial to prevent gangrenous or perforated appendicitis and reduce post-surgery sepsis, especially in young children.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Emergency Medicine

Background:

  • Acute appendicitis is a common surgical emergency in children.
  • Presentation can be typical or atypical, posing diagnostic challenges.
  • Delayed diagnosis is linked to increased morbidity.

Purpose of the Study:

  • To analyze the presentation and outcomes of acute appendicitis in children.
  • To identify factors contributing to delayed diagnosis and treatment.
  • To determine risk factors for postappendectomy sepsis in pediatric patients.

Main Methods:

  • Prospective study of 344 children (3 months to 16 years) with acute appendicitis.
  • Analysis of clinical presentation, diagnostic delays, and surgical outcomes.

Related Experiment Videos

  • Identification of risk factors for postappendectomy sepsis.
  • Main Results:

    • Most children (70%) presented with typical appendicitis features; atypical presentations were rare (7 children).
    • Prolonged delay (especially >37 hours) significantly increased the incidence of gangrenous and perforated appendicitis.
    • Key delays stemmed from parental and primary care recognition issues; young children (<6 years) faced higher sepsis risk due to late diagnosis, not inherent susceptibility.

    Conclusions:

    • Early recognition of acute appendicitis in children is critical to prevent progression to complicated disease.
    • Parental and primary care education is essential to reduce diagnostic delays.
    • Strategies to decrease postappendectomy morbidity should focus on timely diagnosis and appropriate management, particularly for young children.