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Appendicitis in Children Aged 5 Years and Under - Abstract

G. Shepherd , S. Jayakumar , A. Rajimwale , R. Fisher , G. Ninan , S. Nou

 

Abstract

Purpose: To examine the presentation, investigation, histological diagnosis and outcome of patients who underwent acute appendicectomy in children aged 5 years and under.

Methods: This is a retrospective case note review of all children aged 5 years and under who underwent emergency appendicectomy at our institution over a two-year period.

Results: Two hundreds and seventy-two patients underwent emergency appendicectomy for a clinical diagnosis of appendicitis. Twenty-three patients were 5 years of age or less (8%) with 11 boys and 12 girls. Three had perforated appendicitis (13%), 13 had non-perforated appendicitis (57%). Six had normal appendicectomies (26%), of which 2 had Meckel’s diverticulitis (9%) and 1 had enterobius vermicularis infestation (4%). Twenty patients had blood sampling for inflammatory markers (87%). Ultrasound was performed in 8 cases (35%). One patient had an intra-abdominal collection post perforated appendicitis (4%) and one patient had an incisional hernia (4%).

Conclusion: Accurate diagnosis of acute appendicitis in this age group remains challenging. Adjuncts to clinical assessment are frequently employed but their accuracy remains poor. The relative low incidence of acute appendicitis in very young children means that it is often overlooked. A high index of suspicion may aid earlier diagnosis and thereby reduce morbidity and length of hospital stay.

Keywords: appendicitis, appendicectomy, young children, pre-school age

 

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