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Early childhood appendicitis is still a difficult diagnosis
Author(s) -
Paajanen H,
Somppi E
Publication year - 1996
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1996.tb14061.x
Subject(s) - medicine , leukocytosis , appendix , perforation , appendicitis , peritonitis , iliac fossa , acute appendicitis , surgery , mortality rate , general surgery , paleontology , materials science , metallurgy , punching , biology
We report on 90 pre‐school children operated on for suspected acute appendicitis. The data analysis was retrospective. The outcome of exploration was negative in 54% (49/90) of cases; inflamed non‐perforated appendix was removed in 28% (25/90) and a perforated appendix in 18% (16/90) of cases. In infants aged >3 years ( n = 26) the perforation rate was 60%, and in children aged 4‐5 years ( n = 64) it was 27%. Tenderness in the iliac fossa, blood leukocytosis and urinanalysis had little diagnostic value. Preoperative signs of diffuse peritonitis and elevated values of serum C‐reactive protein were found more frequently only in the children with a perforated appendix. There was no mortality and the postoperative morbidity varied between 10 and 20%. Thus, although appendectomy is currently a safe procedure in children, more specific non‐invasive diagnostic aids are still needed to reduce the number of negative explorations and the rate of perforation.