Acute appendicitis is the most common disorder in childhood requiring intraabdominal surgery and presents more serious problems than adults because of a higher perforation rate. Complicated appendicitis continues to be associated with significant
morbidity.
Although appendectomy is the principle of treatment, the best method to improve the morbidity of perforated appendicitis in children remains controversial.
From January 1986 to August 1995, 107 children with acute appendicitis were operated on at the Chonnam University Hospital, a tertiary referral center.
Complicated, gangrenous or perforated appendicitis was noted in 57.9% of total patients and 88.2% of patients age 6 years and younger. The mean duration of symptoms prior to the visit to the emergency room was 3.9 days in complicated cases
compared
with
2.1 days in simple cases(p<0.001). Postoperative complications developed in 24.2%(in simple cases, 2.2%; p<0.005) and wound infection in 17.7%. A transperitoneal drain was used in 51.6%(none in simple case) and wound complications developed in
12.5% in
the drainage and 23.3% in the non-drainage group(not significant). The average length of hospital stay was 9.9 days in complicated cases(5.5 days in simple cases; p<0.0005).
In complicated appendicitis in children, utilization of antibiotics. Peritoneal irrigation, and peritoneal drainage is required for better results.
|