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Acute appendicitis in the under-5 year old
1Department of Paediatric Surgery, University Hospital, Nottingham, UK.
Journal of the Royal College of Surgeons of Edinburgh
|June 1, 1994
Summary
Acute appendicitis in children under five is rare but often overlooked. Early diagnosis is crucial, as a high perforation rate of 50% was observed in this age group, though mortality was zero.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Acute appendicitis is a common surgical emergency in children.
- Appendicitis in children under five years old is infrequent and poses diagnostic challenges.
Purpose of the Study:
- To analyze the clinical presentation, management, and outcomes of acute appendicitis in children under five years of age.
- To identify factors contributing to delayed diagnosis and high perforation rates in this pediatric population.
Main Methods:
- Retrospective analysis of 36 children under five diagnosed with acute appendicitis over a 10-year period.
- Review of medical records to assess symptoms, diagnostic delays, surgical management, and postoperative complications.
Main Results:
- Abdominal pain was present in 32/36 children; vomiting in 28/36.
- Right iliac fossa tenderness was noted in 21/36, generalized tenderness in 10/36.
- A 50% perforation rate was observed, inversely proportional to age; wound sepsis rate was 16.6%; no mortality.
Conclusions:
- Acute appendicitis in very young children is often missed due to its low incidence and atypical presentations.
- A high index of suspicion is essential for timely diagnosis and to mitigate the significant morbidity associated with delayed treatment in this age group.