Clinical outcomes of acute appendicitis in children and the impact of diagnostic delay on its complications

Abstract EN

Background: Acute appendicitis is the most common condition in children requiring emergency abdominal surgery.

The key to a successful outcome is early diagnosis followed by appendectomy before gangrene or perforation develops.: Aim of study: To analyze the time of presentation and complication s of acute appendicitis Patients and Methods: This is a retrospective study conducted in Al –Mustansiria Hospital over a period of three years from January 2005 to January 2008 .Data were collected from the patients case sheets.

The patients were then divided into two groups according to the length of diagnostic period , group A including those children who presented in the first 48 hours after the onset of symptoms, and group B including those children who presented beyond the 48 hours after the onset of symptoms.

Then the patients were subdivided into three age groups (<5 years,5-11 years ,and> 11 years).

Results: Total number of (105) children with acute appendicitis were operated upon in Al- Mustansiria Hospital over a period extending from January 2005 to January 2008.

63 (60%) were males and 42 (40%) of the patients were females; and the male to female ratio was 1.5:1.

38(36.2%) children fall into group A, while 67(63%) children fall into group B.

Perforated appendicitis was observed in 25 out of the 105 patients (23.8%) when differentiated by age, perforation is more common in young children, both in group A and group B.

Perforation were more frequent in group B compared to group A, 21 out of 63 (33.3%) and 4 out of 42 respectively.

This was associated with higher incidence of post operative complications, 4 out of 42(9.5%) in group A and 21 out of 63 (33.3%) in group B (p>0.05).

Four children from group A with non perforated appendix had wound infection .Of those cases in group A , non had perforation and non had postoperative paralytic ileus .Wound infection was observed in15 out of 63of children in group B(23.8%).Postoperative praralytic ileus was observed in 6 out of 63children in group B(9.5%).Postoperative complication in both groups.