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Childhood appendicitis in Zaria: a retrospective study
1Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Insights
Childhood appendicitis in Africa is underreported. This study highlights common symptoms and signs, revealing high rates of perforation and gangrene, with a significant mortality rate of 9% in pediatric appendicitis cases.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Epidemiology
Background:
- Limited data exists on childhood appendicitis in Africa.
- Appendicitis is a common surgical emergency in children globally.
- Understanding regional variations is crucial for effective healthcare.
Purpose of the Study:
- To describe the clinical presentation and outcomes of childhood appendicitis in an African setting.
- To identify common symptoms and signs associated with appendicitis in pediatric patients.
- To determine the incidence of complications and mortality rates.
Main Methods:
- Retrospective analysis of 207 pediatric appendicitis cases operated between 1981-1990.
- Detailed review of 44 patient records from the last two years of the study period.
- Data collection on patient demographics, symptoms, signs, operative findings, and outcomes.
Main Results:
- Common symptoms included vague abdominal pain, vomiting, constipation, and fever.
- Key signs were high-grade fever, dehydration, and abdominal tenderness.
- High rates of complications were observed: 26.6% uncomplicated appendicitis in the larger group, 45.5% perforation in the smaller group.
- Mortality rate was 9% (4 deaths).
Conclusions:
- Childhood appendicitis in this African cohort frequently presents with advanced complications like perforation and gangrene.
- Prompt diagnosis and surgical intervention are critical to reduce morbidity and mortality.
- Further prospective studies are needed to confirm these findings and guide public health strategies.
Abstract:
Very little had been reported about childhood appendicitis from Africa. This retrospective report comprises two parts. One part is an overview of appendicitis in 207 children operated upon between January, 1981 and December, 1990 and the other involved a detailed study of 44 patients seen in the last 2 years of that decade. Overall, there were 135 males and 72 females, aged 4 years and younger than 15 years. 78 children were operated upon between 1989 and 1990 and only the records of 44 patients had detailed enough information for inclusion in this study. The common symptoms of appendicitis in children were: vague abdominal pain, vomiting, constipation and fever. The common signs were high grade pyrexia, dehydration, generalized or localized abdominal tenderness. In the larger group, 105 patients presented with perforation, 47 with gangrene, only 26.6% presented with uncomplicated appendicitis. In the smaller group 45.5% presented with perforation, 8 patients had wound infection. Four patients died; giving a mortality of 9%.
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