Outcomes of acute appendicitis in patients younger than age 4: a descriptive study
Abstract Background Acute appendicitis is an infrequent pathology in children under 4 years of age, and its diagnosis is a clinical challenge that can lead to late detection. The intention of this study is to describe the clinical and surgical findings and to explore factors and outcomes associated...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-08-01
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| Series: | Annals of Pediatric Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43159-022-00196-x |
| _version_ | 1811340349773185024 |
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| author | Jhon Camacho-Cruz Patricia Ocampo Padilla Daniela Guerrero Sánchez Diana Milena Mongui Laura Katherine Hoyos María Lucia Porras Pablo Vásquez Hoyos Fernando Polo Carlos Alberto Castro |
| author_facet | Jhon Camacho-Cruz Patricia Ocampo Padilla Daniela Guerrero Sánchez Diana Milena Mongui Laura Katherine Hoyos María Lucia Porras Pablo Vásquez Hoyos Fernando Polo Carlos Alberto Castro |
| author_sort | Jhon Camacho-Cruz |
| collection | DOAJ |
| description | Abstract Background Acute appendicitis is an infrequent pathology in children under 4 years of age, and its diagnosis is a clinical challenge that can lead to late detection. The intention of this study is to describe the clinical and surgical findings and to explore factors and outcomes associated with appendiceal perforation in patients under 4 years of age with histologically confirmed acute appendicitis. Cross-sectional study of historical data is on patients with a pathologic diagnosis of appendicitis. Clinical, surgical, and pathological variables were described. The relationship between the presence of perforation and associated factors and outcomes was explored using odds ratios (OR) and 95% confidence intervals. Results Seventy-five patients were found between 2013 and 2019. Seventy-four cases presented with pain on palpation, 56 (75%) with signs of peritoneal irritation, and 70 (93%) with sepsis on admission to the emergency room. An ultrasound was done on 57 patients (76%), and only 26 (45%) were suggestive of appendicitis. Forty-one (55%) cases were operated on by open surgery and 34 (45%) by laparoscopy. In 61 (81%), they were perforated, and 48 (64%) presented peritonitis. Perforation was associated with increased hospital days (OR = 2.54 [1.60−4.03]), days of antibiotics (OR = 4.40 [2.09−9.25]), and admission to intensive care (OR = 9.65 [1.18−78.57]). Conclusions Abdominal pain reported by parents, pain on abdominal palpation, and clinical criteria of sepsis on admission to the emergency room are common features. Acute appendicitis complicated by perforation leads to high morbidity due to longer antibiotic treatment, hospitalization days, admission to PICU, and postoperative ileus. |
| first_indexed | 2024-04-13T18:40:43Z |
| format | Article |
| id | doaj.art-5898515815194b0a819e38d3a738a72d |
| institution | Directory Open Access Journal |
| issn | 2090-5394 |
| language | English |
| last_indexed | 2024-04-13T18:40:43Z |
| publishDate | 2022-08-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Pediatric Surgery |
| spelling | doaj.art-5898515815194b0a819e38d3a738a72d2022-12-22T02:34:43ZengSpringerOpenAnnals of Pediatric Surgery2090-53942022-08-011811810.1186/s43159-022-00196-xOutcomes of acute appendicitis in patients younger than age 4: a descriptive studyJhon Camacho-Cruz0Patricia Ocampo Padilla1Daniela Guerrero Sánchez2Diana Milena Mongui3Laura Katherine Hoyos4María Lucia Porras5Pablo Vásquez Hoyos6Fernando Polo7Carlos Alberto Castro8Department of Pediatrics, Hospital de San José — Sociedad de Cirugía de Bogotá, Fundación Universitaria de Ciencias de la Salud (FUCS)Department of Pediatric Surgery, Hospital Infantil Universitario de San José, Fundación Universitaria de Ciencias de la Salud (FUCS)Department of Pediatrics, Hospital de San José — Sociedad de Cirugía de Bogotá, Fundación Universitaria de Ciencias de la Salud (FUCS)Department of Pediatrics, Hospital de San José — Sociedad de Cirugía de Bogotá, Fundación Universitaria de Ciencias de la Salud (FUCS)Department of Pediatrics, Hospital de San José — Sociedad de Cirugía de Bogotá, Fundación Universitaria de Ciencias de la Salud (FUCS)Department of Pediatric Surgery, Hospital Infantil Universitario de San José, Fundación Universitaria de Ciencias de la Salud (FUCS)Department of Pediatrics, Hospital de San José — Sociedad de Cirugía de Bogotá, Fundación Universitaria de Ciencias de la Salud (FUCS)Department of Pathology, Hospital de San José — Sociedad de Cirugía de Bogotá, Hospital Infantil Universitario de San José, Fundación Universitaria de Ciencias de la Salud (FUCS)Research Division, Fundación Universitaria De Ciencias De La Salud (FUCS)Abstract Background Acute appendicitis is an infrequent pathology in children under 4 years of age, and its diagnosis is a clinical challenge that can lead to late detection. The intention of this study is to describe the clinical and surgical findings and to explore factors and outcomes associated with appendiceal perforation in patients under 4 years of age with histologically confirmed acute appendicitis. Cross-sectional study of historical data is on patients with a pathologic diagnosis of appendicitis. Clinical, surgical, and pathological variables were described. The relationship between the presence of perforation and associated factors and outcomes was explored using odds ratios (OR) and 95% confidence intervals. Results Seventy-five patients were found between 2013 and 2019. Seventy-four cases presented with pain on palpation, 56 (75%) with signs of peritoneal irritation, and 70 (93%) with sepsis on admission to the emergency room. An ultrasound was done on 57 patients (76%), and only 26 (45%) were suggestive of appendicitis. Forty-one (55%) cases were operated on by open surgery and 34 (45%) by laparoscopy. In 61 (81%), they were perforated, and 48 (64%) presented peritonitis. Perforation was associated with increased hospital days (OR = 2.54 [1.60−4.03]), days of antibiotics (OR = 4.40 [2.09−9.25]), and admission to intensive care (OR = 9.65 [1.18−78.57]). Conclusions Abdominal pain reported by parents, pain on abdominal palpation, and clinical criteria of sepsis on admission to the emergency room are common features. Acute appendicitis complicated by perforation leads to high morbidity due to longer antibiotic treatment, hospitalization days, admission to PICU, and postoperative ileus.https://doi.org/10.1186/s43159-022-00196-xAppendicitisPerforated appendicitisChildrenDiagnostic studyUltrasoundPathology |
| spellingShingle | Jhon Camacho-Cruz Patricia Ocampo Padilla Daniela Guerrero Sánchez Diana Milena Mongui Laura Katherine Hoyos María Lucia Porras Pablo Vásquez Hoyos Fernando Polo Carlos Alberto Castro Outcomes of acute appendicitis in patients younger than age 4: a descriptive study Annals of Pediatric Surgery Appendicitis Perforated appendicitis Children Diagnostic study Ultrasound Pathology |
| title | Outcomes of acute appendicitis in patients younger than age 4: a descriptive study |
| title_full | Outcomes of acute appendicitis in patients younger than age 4: a descriptive study |
| title_fullStr | Outcomes of acute appendicitis in patients younger than age 4: a descriptive study |
| title_full_unstemmed | Outcomes of acute appendicitis in patients younger than age 4: a descriptive study |
| title_short | Outcomes of acute appendicitis in patients younger than age 4: a descriptive study |
| title_sort | outcomes of acute appendicitis in patients younger than age 4 a descriptive study |
| topic | Appendicitis Perforated appendicitis Children Diagnostic study Ultrasound Pathology |
| url | https://doi.org/10.1186/s43159-022-00196-x |
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