The acute abdomen defined as an acute abdominal condition which needs immediate decision for treament is one of the most common surgical conditions in children.
337 infants and children with acute abdominal condition except neonate under 1-month old were admitted to the Pediatric Surgical Division of the Surgical Department between July 1986 and January 1990. It was 29.9% of total admissions in the
Pediatric
Surgical Division. The sex ratio was 1.9 : 1. Intestinal obstruction was the most common acute abdominal condition(43.9%) and it was followed by inflammatory disease(38.6%), abdominal trauma(14.5%) and gastrointestinal bleeding(3.0%). The most
common
disease was appendicitis in 97 cases, and 49 children had abdominal trauma, intussusception in 35 cases, intestinal obstruction due to postoperative band adhesion in 32, hypertophic pyloric stenosis in 27 and intestinal obstruction by congenital
anomalies in 24. But the disease distribution was much different according to age. Obstructing pathology was the main cause of the acute abdomen in infants and younger children and inflammatory diasease like appendicitis was the most common
condition in
older children. The incidence of appendicithis was very low in younger children but the perforation rate was very high, 77.8% in children between two and five year-old, and 45.5% between six an ten year-old.
The operation underwent in 98 of 124 patients who were admitted under the initial diagnosis of appendicitis and the appendicitis was finaly confirmed in 97 childern. The patients with intestinal obstruction by postoperative adhesion had operation
in
59.4% and the rest recovered with conservative management. The operation rate for the abominal trauma was 38.8% and the operation underwent in 37.5% of patients with hepatic trauma, 47.1% with splenic trauma and 60% with pancreatic injury. The
operative
complication occurred in 17 cases(6.6%) and one patient died of sepsis.
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