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Management of peritonitis in perforated appendicitis in children

I Evbuomwan1, O N Onwanyin

  • 1Department of Surgery, University of Benin Teaching Hospital, Nigeria.

Insights

This study shows that a structured approach to severe appendicitis, including preoperative care, careful surgery, antibiotics, and early patient movement, leads to low complication rates and short hospital stays.

Area of Science:

  • Surgical Gastroenterology
  • Infectious Diseases

Background:

  • Severe acute appendicitis with gangrene and perforation presents significant management challenges.
  • Standard treatment protocols are crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate a structured management protocol for severe acute appendicitis with gangrene and perforation.
  • To assess the efficacy of the protocol in reducing complications and hospital stay.

Main Methods:

  • Prospective study implementing a standardized treatment protocol.
  • Protocol included preoperative optimization, meticulous surgical technique, combination antibiotic therapy, and early ambulation.
  • Data collected on hospital stay, wound infection, morbidity, and long-term complications.

Main Results:

  • Average hospital stay was seven days.
  • Wound infection rate was less than 1% and mild in degree.
  • Overall morbidity was low, with no serious complications reported during follow-up.

Conclusions:

  • The implemented schematized treatment protocol is effective for managing severe acute appendicitis.
  • This approach significantly reduces complications and shortens hospital stays.
  • Early ambulation and comprehensive perioperative care are key components for successful outcomes.

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