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Perforated appendicitis: current experience in a Childrens Hospital

M B Marchildon, D L Dudgeon

    Annals of Surgery
    |January 1, 1977
    PubMed

    Insights

    Surgical treatment of perforated appendicitis in children resulted in no deaths and a 17% complication rate. Key factors included resuscitation, broad-spectrum antibiotics targeting anaerobic bacteria, and surgical precision.

    Area of Science:

    • Pediatric Surgery
    • Infectious Diseases

    Background:

    • Perforated appendicitis is a serious condition in children.
    • High morbidity and mortality rates have historically been associated with this condition.

    Purpose of the Study:

    • To review outcomes of surgically treated perforated appendicitis in pediatric patients.
    • To identify factors contributing to low morbidity and mortality.

    Main Methods:

    • Retrospective review of 89 consecutive cases of perforated appendicitis.
    • Analysis of surgical management, preoperative resuscitation, antibiotic protocols, and postoperative outcomes.
    • Microbiological cultures of peritoneal fluid and blood.

    Main Results:

    • No mortality was observed in the 89 cases.
    • A complication rate of 17% was recorded.
    • Anaerobic organisms were consistently found in peritoneal fluid and blood cultures, often implicated in infectious complications.

    Conclusions:

    • Adequate preoperative resuscitation, meticulous surgical technique, and the use of broad-spectrum antibiotics effective against anaerobes are crucial for minimizing complications.
    • Targeting anaerobic organisms in antibiotic regimens is essential for managing perforated appendicitis effectively.

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