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[Appendicitis in children under 3]
C Baeza Herrera1, O Guido Ramires, J A González Galicia
1Departamento de Cirugía, Hospital Pedriático Moctezuma, México, D.F.
Insights
Acute appendicitis in children under three years old often leads to perforation. Delayed diagnosis, indicated by prolonged symptoms, significantly increases complication rates in this vulnerable age group.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Infectious Diseases
Context:
- Acute appendicitis presents unique challenges in children under three years old compared to older children.
- Understanding the specific responses to intra-abdominal infections in infants is crucial for reducing morbidity.
- Supportive treatment plays a vital role in managing young children with acute appendicitis.
Purpose:
- To investigate the factors contributing to the high perforation rate in acute appendicitis among children under three years of age.
- To analyze the clinical presentation and outcomes of appendectomy in this specific pediatric demographic.
Summary:
- A retrospective analysis of 88 patients (4-35 months old) undergoing appendectomy revealed significant differences in acute appendicitis presentation.
- The majority of patients (80%) experienced symptoms for over 24 hours, with 90% presenting with peritonitis.
- Common symptoms included fever, pain, and vomiting; abdominal radiographs often indicated small bowel obstruction.
Impact:
- The study highlights that the duration of symptoms is directly proportional to the rate of complications in young children with acute appendicitis.
- Findings underscore the need for prompt diagnosis and intervention to mitigate the high perforation and morbidity rates.
- This research contributes to improving the management and outcomes for infants and toddlers diagnosed with acute appendicitis.
Abstract:
There are many differences between acute appendicitis in the older child and the infants. An understanding of the under three years of age child's response to intra-abdominal infection in contrast to that of the older child and an appreciation for the supportive treatment of the child are vitally important in further lowering the morbidity of young children with acute appendicitis. The purpose of the present study was to investigate the factors contributing to the high perforation rate seen in this age group. A retrospective analysis was done in 88 patients under the age of three who underwent appendectomy. These patients ranged from 4 and 35 months in age. There were 51 (77.4%) male patients. The main complaints were fever, pain and vomiting. Duration of symptoms was more than 24 hours in 80%. Abdominal radiographs showed signs of small bowel obstruction. Peritonitis was found in the majority of the cases (90%). overall morbidity was 31.8% and mortality 1.1%. These data suggest that duration of symptoms is directly proportional to complications rate.