Related Experiment Videos
Mechanical small-bowel obstruction after conventional appendectomy in children
G Ahlberg1, S Bergdahl, J Rutqvist
1Department of Pediatric Surgery, St. Göran's Children's Hospital, Stockholm, Sweden.
Insights
Appendectomy in children can lead to small bowel obstruction (SBO), a complication observed in 1.3% of patients. Perforated appendicitis cases showed a higher risk of SBO post-surgery.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
Background:
- Appendicitis is a common surgical emergency in children.
- Laparotomy for appendicitis carries potential long-term risks.
Purpose of the Study:
- To evaluate the long-term risk of mechanical small bowel obstruction (SBO) after childhood appendectomy.
- To determine if the severity of appendicitis influences SBO risk.
Main Methods:
- Retrospective analysis of 871 children (0-15 years) who underwent appendectomy via laparotomy.
- Follow-up period of 4-6 years post-surgery.
- Subgroup analysis based on appendicitis severity: normal appendix, simple, gangrenous, and perforated appendicitis.
Main Results:
- 1.3% (10/791) of patients developed SBO requiring re-operation.
- SBO risk was 1.8% for normal appendix, 0% for simple appendicitis, 0.4% for gangrenous appendicitis, and 3.4% for perforated appendicitis.
- No mortality from postoperative complications; two unrelated deaths during follow-up.
Conclusions:
- Childhood appendectomy, particularly for perforated appendicitis, is associated with a long-term risk of mechanical small bowel obstruction.
- Surveillance for SBO is warranted in pediatric patients following appendectomy.
Abstract:
During the period May 1988 to August 1990, 871 children aged between 0 and 15 years were appendectomized by laparotomy because of suspected appendicitis at the department of pediatric surgery, St. Göran's Children's Hospital. The children were followed 4-6 years after appendectomy. 1.3 % (10/791) developed clinical symptoms consistent with mechanical small bowel obstruction (SBO) resulting in relaparotomy and confirmation of the diagnosis. The patients were divided into subgroups according to the degree of appendicitis. In the group with normal appendix 1.8% (3/170) developed mechanical SBO, simple appendicitis 0% (0/209), gangrenous appendicitis 0.4 % (1/236) and perforated appendicitis 3.4% (6/176). There was no mortality due to postoperative complications. Two patients died due to unrelated causes during the follow-up period.