Journal of Pharmaceutical and Biomedical Sciences

Paediatric Appendicitis: Three-year Experience in a Secondary Care Hospital

Satya Ranjan Patra, Saji Vargheese, Nilesh P. Patil, Harshita Mehrotra, Arnab Saha

Abstract


Objective To analyze cases of acute appendicitis in the pediatric population and find the effectiveness of ultrasonography and laparoscopic appendectomy in patients attending the referral hospital of Andaman & Nicobar Islands.

Materials and Methods A three-year retrospective analysis of pediatric appendicitis cases who underwent emergency appendectomy in GB Pant Hospital Port Blair between June 2014 and June 2017.

Results During the three-year study period, 59 children underwent emergency appendectomy. They were 32 (54%) boys and 27 (46%) girls. The cases of uncomplicated appendicitis were 43 (73%) and that of complicated appendicitis were 16 (27%). The
most common symptom was pain in the abdomen, which was present in 54 (91.5%) of cases. Lower abdomen tenderness was the most common finding on physical examination, which was found in 55 (93.2%) of the cases. Ultrasound was diagnostic in 54
(91.5%) of the cases. Laparoscopic Appendectomy was done in 55 (93.2%) of the cases.


Keywords


pediatric appendicitis, ultrasound, laparoscopic appendectomy

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References


Bansal S, Banever GT, Karrer FM, Partrick DA. Appendicitis in children less than 5 years old: influence of age on presentation and outcome. American J Surg. 2012;204:1031–1035.

Reynolds SL. Missed appendicitis in a pediatric emergency department. Pediatr Emerg Care. 1993;9:1–3.

Kambouri K, Aggelidou M, Tsalkidis A, Vaos G, Gardikis S. Risk factors for delay in diagnosing acute appendicitis. Indian J Pediatr. 2017;84:491.

Di Saverio S, Birindelli A, Kelly MD, Catena F, Weber DG, Sartelli M, et al. WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis. World J Emerg Surg. 2016;11:34.

Andersson RE. Meta-analysis of the clinical and laboratory diagnosis of appendicitis. Br J Surg. 2004;91:28–37.

Wang LT, Prentiss KA, Simon JZ, Doody DP, Ryan DP. The use of white blood cell count and left shift in the diagnosis of appendicitis in children. Pediatr Emerg Care. 2007;23:69–76.

Anandalwar SP, Callahan MJ, Bachur RG, Feng C, Sidhwa F, Karki M, et al. Use of white blood cell count and polymorphonuclear leukocyte differential to improve the predictive value of ultrasound for suspected appendicitis in children. J Am Coll Surg. 2015;220:1010–1017.

Prada Arias M, Salgado Barreira A, Montero Sánchez M, Fernández Eire P, García Saavedra S, Gómez Veiras J, et al. Appendicitis versus non-specific acute abdominal pain: paediatric appendicitis score evaluation. An Pediatr (Barc). 2017; pii: S1695-4033(17)30015-2.

Chang YJ, Chao HC, Chen CL, Chen SY, Yan DC, Tsai MH. C-reactive protein may predict the recurrence of appendicitis in children formerly with appendiceal mass after successful non-operative treatment. Pediatr Neonatol. 2017;58:350–354.

Mittal MK, Dayan PS, Macias CG, Bachur RG, Bennett J, Dudley NC, et al. Pediatric emergency medicine collaborative research committee of the American Academy of Pediatrics. Performance of ultrasound in the diagnosis of appendicitis in children in a multicenter cohort. Acad Emerg Med. 2013;20:697–702.

Reddan T, Corness J, Mengersen K, Harden F. Ultrasound of paediatric appendicitis and its secondary sonographic signs: providing a more meaningful finding. J Med Radiat Sci.2016;63:59–66.

Saito JM, Yan Y, Evashwick TW, Warner BW, Tarr PI. Use and accuracy of diagnostic imaging by hospital type in pediatric appendicitis.Pediatrics. 2013;131:e37–e44.

Raval MV, Deans KJ, Rangel SJ, Kelleher KJ, Moss RL. Factors associated with imaging modality choice in children with appendicitis. J Surg Res. 2012;177:131–136.

Kaiser S, Frenckner B, Jorulf HK. Suspected appendicitis in children: US and CT—a prospective randomized study. Radiology. 2002;223:633–638.

Doria AS, Moineddin R, Kellenberger CJ, Epelman M, Beyene J, Schuh S, et al. US or CT for diagnosis

of appendicitis in children and adults? a meta-analysis.Radiology. 2006;241:83–94.

Aspelund G, Fingeret A, Gross E, Kessler D, Keung C, Thirumoorthi A, et al. Ultrasonography/MRI versus CT for diagnosing appendicitis.Pediatrics. 2014;133:586–593.

Didier RA, Hopkins KL, Coakley FV, Krishnaswami S, Spiro DM, Foster BR. Performance characteristics of magnetic resonance imaging without contrast agents or sedation in pediatric appendicitis. Pediatr Radiol. 2017.

Huang L, Yin Y, Yang L, Wang C, Li Y, Zhou Z. Comparison of antibiotic therapy and appendectomy for acute uncomplicated appendicitis in children: a meta-analysis. JAMA Pediatr. 2017;171:426–434.

López JJ, Deans KJ, Minneci PC. Nonoperative management of appendicitis in children. Curr Opin Pediatr. 2017;29:358–362.

Xu J, Adams S, Liu YC, Karpelowsky J. Nonoperative management in children with early acute appendicitis: a systematic review. J Pediatr Surg. 2017;52:1409–1415.

Gonzalez DO, Deans KJ, Minneci PC. Role of non-operative management in pediatric appendicitis. Semin Pediatr Surg.2016;25:204–207.

Serres SK, Cameron DB, Glass CC, Graham DA, Zurakowski D, Karki M, et al. Time to appendectomy and risk of complicated appendicitis and adverse outcomes in children.JAMA Pediatr. 2017;171:740–746.

Esposito C, Calvo AI, Castagnetti M, Alicchio F, Suarez C, Giurin I, et al. Open versus laparoscopic appendectomy in the pediatric population: a literature review and analysis of complications. J Laparoendosc Adv Surg Tech A. 2012;22:834–839.

Hernandez-Martin S, Ayuso L, Molina AY, Pison J, Martinez-Bermejo MA, Perez-Martinez A. Transumbilical laparoscopic-assisted appendectomy in children: is it worth it?. Surg Endosc. 2017.


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