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Primary peritonitis in children
1Department of General Surgery, Royal Children's Hospital, Melbourne, Victoria, Australia.
Insights
Primary peritonitis remains uncommon in children, with incidence unchanged since 1970. This condition predominantly affects females without a clear cause, while males typically have underlying medical issues.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Abdominal Medicine
Background:
- Primary peritonitis is a rare cause of acute abdomen in children.
- Often diagnosed during surgery for appendicitis or via paracentesis in medically compromised children.
Purpose of the Study:
- To review the experience with primary peritonitis at a children's hospital over 5 years.
- To compare current findings with a series from 25 years prior.
Main Methods:
- Retrospective review of pediatric primary peritonitis cases.
- Comparison of incidence and patient demographics over two time periods.
Main Results:
- 26 cases identified between 1989-1994, with 85% female patients.
- 23% of patients had significant underlying medical disorders.
- Incidence remained stable at 4.7 cases per year; neonatal cases are no longer observed.
Conclusions:
- Primary peritonitis incidence is stable, but neonatal cases have disappeared.
- Female cases often lack clear etiology, suggesting genital tract transmission.
- Male cases are rare and linked to underlying conditions like alpha-1-antitrypsin deficiency and renal disease.
Background:
Primary peritonitis is a rare cause of the acute abdomen in children. It is often found at laparotomy for suspected appendicitis, or diagnosed by paracentesis in a child with an associated medical disorder.
Methods:
Our experience over the past 5 ++years with this condition at the Royal Children's Hospital is reviewed and compared with a larger series previously published from the same institution 25 years ago.
Results:
There were 26 cases from 1989 to 1994; 22 (85%) were female and 6 (23%) of the patients had a major underlying medical disorder.
Conclusions:
The incidence of primary peritonitis has remained unchanged at this institution since 1970 (4.7 cases per year), but neonatal primary peritonitis is no longer seen. Primary peritonitis is more common in females in whom there is no clear aetiology, but is presumed to be related to the retrograde passage of organisms through the genital tract. By contrast, in males primary peritonitis is rare but may be related to underlying medical conditions such as alpha-1-antitrypsin deficiency and renal disease.