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[Appendicitis in childhood].

R Grüssner, G Pistor, R Engelskirchen

    Monatsschrift Kinderheilkunde : Organ Der Deutschen Gesellschaft Fur Kinderheilkunde
    |March 1, 1985
    PubMed
    Summary
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    Appendectomy in children reveals that 22% of cases lack clear surgical indication. Acute appendicitis has higher complication rates, while non-acute cases show fewer risks, suggesting careful patient selection is crucial.

    Area of Science:

    • Pediatric Surgery
    • Gastroenterology
    • Pathology

    Background:

    • Retrospective analysis of 1,059 pediatric appendectomies performed between 1975 and 1983.
    • Evaluation of histopathological and intraoperative findings to assess the indication for appendectomy.

    Observation:

    • Five histological types of appendicitis were identified: acute (ulcerophlegmonous, superficial), chronic, lymphatic hyperplasia, submucosal fibrosis, and rare diseases.
    • Acute appendicitis confirmed in 58.3% of cases; other intraoperative findings mimicking appendicitis in 19.2%.
    • 22% of appendectomies were retrospectively deemed unnecessary based on findings.

    Findings:

    • Postoperative complication rates significantly correlated with histopathological findings.
    • Perforated ulcerophlegmonous appendicitis had the highest complication rate (34%), followed by non-perforated (10%).

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  • Acute superficial appendicitis, lymphatic hyperplasia, and submucosal fibrosis showed lower complication rates (5-6%).

    • Implications:

    • Non-acute appendicitis justifies a broad indication for appendectomy due to low complication rates.
    • High-risk pediatric patients, such as those with malformations, require careful consideration and potentially preoperative sonography.
    • Relaparotomies were primarily needed for acute appendicitis cases, highlighting the importance of accurate diagnosis.