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Importance of diarrhea as a presenting symptom of appendicitis in very young children

J R Horwitz1, M Gursoy, T Jaksic

  • 1Division of Pediatric Surgery, University of Texas Medical School, Houston, UK.

American Journal of Surgery
|February 1, 1997
PubMed

Insights

Appendicitis in children under three is often delayed, leading to perforation. Diarrhea complicates diagnosis, predicting longer hospital stays for pediatric appendicitis patients.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Clinical Medicine

Background:

  • Appendicitis is rare in children under 3 years old.
  • Diagnosis is often delayed, leading to perforation and extended hospital stays.

Purpose of the Study:

  • To review appendicitis cases in children under 3.
  • Identify predictors of prolonged hospital stays in this age group.

Main Methods:

  • Retrospective case series of children under 3 undergoing appendectomy (1983-1994).
  • Multiple regression analysis to determine predictors of prolonged hospital stay.

Main Results:

  • 63 children identified; mean age 2.2 years.
  • Average delay in presentation was 4.3 days; 57% misdiagnosed.
  • Perforation/gangrene (84%) and diarrhea (33%) were common.
  • Perforation/gangrene and diarrhea predicted longer hospital stays.

Conclusions:

  • Appendicitis in young children involves diagnostic delays and high perforation rates.
  • Diarrhea is a key factor confusing diagnosis and delaying treatment.
  • Early diagnosis and management are crucial for pediatric appendicitis.
Abstract

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