Appendicitis in south eastern Nigerian children

One hundred and sixty nine cases of acute appendicitis were seen among 760 children aged to zero to 15 years treated for a variety of acute abdominal emergencies in the University of Calabar Teaching Hospital (UCTH), Calabar, during the period January 1982 to 1991. This condition ranks second among cases of acute abdominal emergencies in this group of patients. Those aged 13 to 15 years formed the majority (59 pc) of the children undergoing appendicectomy. As is the experience of other authors, appendicitis is rare under the age of three years. A female preponderance is observed in our study with a male: female ratio of 1:1,6 in contrast to reports elsewhere. The reason for this reversal is not clear. Parasitic infestation due to Ascaris lumbricoides involved 3 pc of our cases. This may be of significance in the aetiology of this disease. Despite the long delay in surgical intervention, no death was reported. Complications such as gangrene and perforation with peritonitis were recorded in only 8 pc of the patients. This favourable outcome despite a delay in initiating treatment may be related to self-medication with antimicrobials before reporting to the hospital.