We have located links that may give you full text access.
Acute appendicitis in children under 3 years of age. Diagnostic and therapeutic problems.
Medycyna Wieku Rozwojowego 2012 April
AIM: Analysis of diagnostic and therapeutic problems in acute appendicitis in children below 3 years of age.
MATERIAL AND METHODS: The analysis was based on medical data of 53 children under 3 years of age, treated in our department for acute appendicitis in the years 1988-2008. Among 53 children, 29 (53.7%) were admitted directly to the surgical department and 24 (45.3%) were transferred from the regional pediatric department. In the period of 1 month before admission to the surgical department 13 patients (24.5%) were treated as outpatients due to acute respiratory or alimentary tract infection. On the basis of the data from the case histories, the most frequent symptoms and their duration were evaluated, as well as the clinical signs, intraoperative diagnosis and the postoperative course.
RESULTS: The most frequent symptoms and clinical signs in this group of children were: abdominal pain, vomiting and fever, present in 83.0%, 75.5%, and 67.0% patients respectively. The mean time of the symptoms' duration was 3.6 days. The most frequently found physical signs on admission to the surgical ward were: abdominal pain on palpation, increased tonus of abdominal muscles and abdominal distension. On laparotomy gangrenous appendicitis was found in 49% of the children operated. In 24.5% of patients perforation of the appendix was confirmed. Further complications occurred in 9 children (16.9%). The average stay in hospital after the operation lasted 7.9 days.
CONCLUSIONS: 1. Acute appendicitis in small children is a diagnostic problem not only for primary health care doctors but also for experienced pediatricians and pediatric surgeons. 2. Early surgical consultation should be a standard procedure in small children with acute symptoms of various locations when there is accompaning abdominal pain, not reacting to conservative treatment. Surgical consultation is also indicated in children under 3 years of age with relapses of abdominal pain. 3. Clinical signs of appendicitis in children aged less than 3 years, may differ from those in older children due to changes in their immunological reactivity. This problem should be included in under-graduate and post-graduate medical studies.
MATERIAL AND METHODS: The analysis was based on medical data of 53 children under 3 years of age, treated in our department for acute appendicitis in the years 1988-2008. Among 53 children, 29 (53.7%) were admitted directly to the surgical department and 24 (45.3%) were transferred from the regional pediatric department. In the period of 1 month before admission to the surgical department 13 patients (24.5%) were treated as outpatients due to acute respiratory or alimentary tract infection. On the basis of the data from the case histories, the most frequent symptoms and their duration were evaluated, as well as the clinical signs, intraoperative diagnosis and the postoperative course.
RESULTS: The most frequent symptoms and clinical signs in this group of children were: abdominal pain, vomiting and fever, present in 83.0%, 75.5%, and 67.0% patients respectively. The mean time of the symptoms' duration was 3.6 days. The most frequently found physical signs on admission to the surgical ward were: abdominal pain on palpation, increased tonus of abdominal muscles and abdominal distension. On laparotomy gangrenous appendicitis was found in 49% of the children operated. In 24.5% of patients perforation of the appendix was confirmed. Further complications occurred in 9 children (16.9%). The average stay in hospital after the operation lasted 7.9 days.
CONCLUSIONS: 1. Acute appendicitis in small children is a diagnostic problem not only for primary health care doctors but also for experienced pediatricians and pediatric surgeons. 2. Early surgical consultation should be a standard procedure in small children with acute symptoms of various locations when there is accompaning abdominal pain, not reacting to conservative treatment. Surgical consultation is also indicated in children under 3 years of age with relapses of abdominal pain. 3. Clinical signs of appendicitis in children aged less than 3 years, may differ from those in older children due to changes in their immunological reactivity. This problem should be included in under-graduate and post-graduate medical studies.
Full text links
Related Resources
Trending Papers
Heart failure with preserved ejection fraction: diagnosis, risk assessment, and treatment.Clinical Research in Cardiology : Official Journal of the German Cardiac Society 2024 April 12
Proximal versus distal diuretics in congestive heart failure.Nephrology, Dialysis, Transplantation 2024 Februrary 30
Efficacy and safety of pharmacotherapy in chronic insomnia: A review of clinical guidelines and case reports.Mental Health Clinician 2023 October
World Health Organization and International Consensus Classification of eosinophilic disorders: 2024 update on diagnosis, risk stratification, and management.American Journal of Hematology 2024 March 30
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app