Open AccessMisdiagnosed Appendicitis in Children
Author(s) -
Kastriot Haxhirexha,
Agron Dogjani,
Lutfi Zylbeari,
Ferizate Dika Haxhirexha
Publication year - 2018
Publication title -
albanian journal of trauma and emergency surgery
Language(s) - English
Resource type - Journals
eISSN - 2616-4922
pISSN - 2521-8778
DOI - 10.32391/ajtes.v2i2.6
Subject(s) - medicine , perforation , appendicitis , emergency department , acute appendicitis , abscess , complication , general surgery , surgery , retrospective cohort study , surgical emergency , materials science , psychiatry , punching , metallurgy
Background: Appendicitis is the one of the most common emergency abdominal operation in children. It is estimated that appendicitis is diagnosed in about 2 % of children who present to emergency department because of acute abdominal pain1. Timely diagnosis and appendectomy can prevent abscess formation, perforation as well as reducing early and late postoperative complication.Methods: This study is a retrospective review of all children diagnosed with acute appendicitis in our emergency department between January 2015 – 2018. We have compared the clinical features and the results of examinations between two group of patients - those who were diagnosed correctly and have been operated,and those who were misdiagnosed and operated later respectively more than 24 hours after initial control.Results: This study includes fifty-nine children less than sixteen years old, admitted in our clinic and operated due to acute appendicitis. Fifty three (89.9%) of them were hospitalized after the first control, whereas the remining six (10.1 %) were discharged home after the initial control. The misdiagnosed patients were returned in our department less than twenty hours after the first control. Compared with the patients in which the diagnosis was made correctly the misdiagnosed patients in general had lower levels of leukocytes, CRP and temperature.Conclusion: The diagnosis of appendicitis in children can be very difficult because of the atypical features. According to our experience and the data from other studies, still there is not a single test or combination of clinical and laboratory examinations, able to discriminate children with and without acute appendicitis with a high percentage of accuracy.