2005, Number 1
Appendicitis in children of five years of age or less
Vizueth-Ramírez S, Romero-Montes VE, Olvera-Duran JA, Nava-Carrillo AD
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Language: Spanish
References: 8
Page: 11-15
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ABSTRACT
Introduction: The appendicitis is a frequent cause of abdominal surgery in children. Of all the cases, 6% is present in child of 5 years of age or less, with a high rate of perforation enlarging the complications. We want to present our experience in the management of appendicitis in patients of 5 years of age or less.Materials and methods: We revise the expedients of children of 5 years of age or less than they were presented with appendicitis, between May 1999 and April 2004. We analyze age, sex, phase of appendicitis, the duration of symptoms prior to proper diagnosis, type of treatment prior, postoperative length of stay, and complications.
Results. There were 69 cases of appendicitis, 62% corresponded to nonperforated and 38% to perforated. Predominate males. The majority of the children have 4 years old or more. The abdominal pain was presented in more than 97%. The fever was a more constant sign in perforated (96%) that in nonperforated cases (61%). The mean time evolution was 25 hours in nonperforated and 38h in perforated cases. The mean postoperative length of stay was 2.3 and 7.4 days respectively. In both, more than the half of the cases to have been evaluated by a physician prior to the hospital admission. The complications were intestinal obstruction in 3 children and residual abscess in one.
Discussion. Some series report rates of perforation from 63 to 74% in children of 5 years of age or less and 100% in less than 2 years of age. In our study find rate of 38%. The prior medical evaluation did not influence in the perforation rate. It follows being priority the opportune diagnosis and management to diminish the postoperative length stay and the morbidity associated.
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