The mortality and morbidity resulting from acute appendicitis in childhood have shown a significant decline in recent years. This decrease has been attributed to many factors, among which the use of specisc antibacterial agents, proper use of fluid therapy, transfusions, and improvement in pediatric anesthesia have been mentioned. There are, however, certain problems inherent in acute appendicitis which give rise to a fairly high incidence of perforation in younger children.
An analysis of cases of 61 acute appendicitis in children under the age of 15 treated at this institution between July 1, 1958 and December 31, 1962 provided following information.
1) The disease is relatively uncommon under the age of 6 years. Males are affected more than the females, the ratio being 3:2.
2) The disease progresses more rapidly in childhood than in adults and the incidence of peforation is high among children. The over-all perforation rate was 28% in these cases. The incidence of peforation under 9 years of age was 45%, whereas the figure for children older than 9 years was 17%.
3) Earlier diagnosis in these cases requires the knowledge of the anatomic characteristics of the appendix in children, a proper interpretation of the child´s complaints and judicious use of laboratory aids.
4) There was no operative death in this series. The over-all complication rate was 13%.
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