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Conservative Management of Pediatric Patients With Appendicolith Appendicitis Versus Non-appendicolith Appendicitis:

Fatemeh Akbarpoor1, Karen Blanco1, Barbara Bombassaro Masiero2

  • 1Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates.

Journal of Pediatric Surgery
|January 25, 2025
PubMed

Insights

Appendicoliths in pediatric appendicitis decrease conservative treatment success for simple cases, suggesting early surgery. Higher recurrence rates in appendicolith cases may warrant interval appendectomy.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Clinical Outcomes

Background:

  • Appendicoliths are found in up to one-third of pediatric acute appendicitis cases.
  • The impact of appendicoliths on conservative management outcomes is not well-established.

Purpose of the Study:

  • To compare the outcomes of conservative management for pediatric appendicitis with and without appendicoliths.
  • To evaluate the influence of appendicoliths on initial treatment success and recurrence rates.

Main Methods:

  • Systematic review and meta-analysis of observational studies.
  • Searched PubMed, Cochrane, Embase, and Web of Science databases.
  • Included studies compared pediatric appendicolith and non-appendicolith appendicitis managed conservatively.

Main Results:

  • Twelve studies with 814 patients were analyzed; 35% had appendicoliths.
  • No significant difference in initial conservative management success overall (OR 0.70).
  • Lower success in simple appendicitis with appendicoliths (OR 0.42), but not in complicated cases (OR 1.01).
  • Significantly higher recurrence rates observed in appendicolith appendicitis (OR 2.75).

Conclusions:

  • Appendicolith presence negatively impacts conservative management success in simple appendicitis.
  • Interval appendectomy may be considered for appendicolith appendicitis due to higher recurrence risk.
Abstract

Keywords:
AppendicitisAppendicolithConservative managementFecalithPediatric

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