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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.
Summary
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.