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Acute Appendicitis in Children During War Conflict: Results from a Multicenter Study
Gal Becker1,2, Igor Sukhotnik1,2, Nadav Slijper3
1Department Pediatric Surgery, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel.
Journal of Clinical Medicine
|July 12, 2025
Summary
Children near war zones experienced more complicated acute appendicitis during the 2023 conflict. Proximity to conflict increased the rate of severe appendicitis in pediatric patients, highlighting war
Area of Science:
- Pediatric Surgery
- Public Health
- War Medicine
Background:
- War conflicts significantly impact public health and healthcare delivery.
- Assessing the effects of war on pediatric surgical conditions is crucial.
Purpose of the Study:
- To evaluate the incidence and severity of acute appendicitis (AA) in children during the 2023 Israeli-Hamas-Hezbollah war.
- To analyze the influence of proximity to conflict zones on pediatric appendicitis outcomes.
Main Methods:
- Multicenter retrospective cohort study of children (<18 years) admitted with AA.
- Comparison of data from a 2-month period during the 2023 war and a comparable period in 2022.
- Subgroup analysis based on proximity to conflict zones, utilizing statistical tests including Student's t-test and Pearson chi square.
Main Results:
- A higher rate of complicated acute appendicitis was observed during wartime (27% vs. 18%), though not statistically significant.
- Hospitals close to conflict zones saw a doubling in complicated appendicitis rates compared to pre-war (16% vs. 9%, p=0.016).
- Incidence of AA decreased near conflict zones but increased in distant centers; symptom-to-presentation time remained unchanged.
Conclusions:
- Proximity to war zones is linked to an increased rate of complicated appendicitis in children.
- The findings underscore the complex impact of war on pediatric healthcare and well-being.
- Further research is needed to elucidate the specific causes of this association.
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