In clinical analysis of 339 children with the sign of right lower quadrant tenderness under the age of fifteen who were admitted to the department of general surgery of Juang Ang Gil Hospital from January 1987 to December 1990. We concluded as
follows.
1) Urgent operation group to observation group ratio was 3.9 : 1(270: 69).
2) Negative appendectomy rate of urgent operation group(270 cases)was 22.9%(62 cases) and that of 20 explorated cases of observation group (69 cases) was 65.0%(13 cases).
3) Male to female ratio in this study was 1.5 : 1.
4) Abdominal pain, vomiting, nausea, and fever were symptoms of both group in order of frequency. Although no remarkable difference was found between the two groups, upper respiratory tract infection history was slightly more frequent in the
observation group than that of the urgent operation group.
5) The average duration of observation in observation group(69 cases)was 3.0 days and that of twenty explorated cases of observation group was 1.7 days.
6) Rebound tenderness at right lower quadrant area was appeared more frequently in the urgent operation group(227 cases, 84.1%) than that of the observation group(24 cases 34.8%).
7) Fifty six cases in 270 urgent operation group had leukocyte count below 10,000/㎣ and the twenty six cases of those revealed normal appendix(46.4%). But all of 6 explorated cases of observation group revealed normal appendix on exploration So
the
rate of negative appendectomy was higher in observation group.
8) In urgent operation group, 59 cases had neutrophil count below 70%, and the 28 cases revealed normal appendix(47.4%) However, 9 cases of 11 explorated cases of observation group had normal appendix(81.8%). So the rate of negative appendectomy
of the
observation group was greater than that of the urgent operation group.
9) Ultrasonography was performed in 31 cases of 69 observation cases, in which 2 cases showed compatible findings with appendicitis and revealed appendicitis on exploration. 3 cases with negative findings on ultrasonography were explorated, and
only 1
case revealed appendicitis. Therefore there was only 1 false negative finding on ultrasonography.
10) The average duration of hospitalization was 7.6 days in urgent operation group and 4.7 days in observation group.
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