ACUTE APPENDICITIS IN PAEDIATRIC AGE GROUP: CLINICAL AND SURGICAL SPECTRUM AND ITS OUTCOMES
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Keywords
Acute appendicitis, children, clinical presentation, surgical outcomes, diagnostic accuracy, paediatric surgery
Abstract
Background: Appendicitis is one of the most common surgical conditions in children and presents more often in the acute state. Early recognition therefore and follow up care is important to avoid such complications.
Objective: This study was aimed to determine the clinical presentation and diagnostic tools, management plans and outcomes of acute appendicitis in children admitted to Lady Reading Hospital, Peshawar.
Methods: This descriptive cross-sectional study was conducted over 6 months from Sept, 2009 to Feb, 2010 in the Department of Paediatric Surgery, Khalifa Gulnawaz Teaching Hospital, Bannu Medical College, Bannu, Pakistan. A total of 120 children below the age of 18 years with histological proven diagnosis of acute appendicitis were enrolled. Demographic details, clinical profile, investigations, surgical treatment were provided, and last follow-up data were recorded in a specially designed data collection format or proforma. The statistical analyses were conducted, and the data was described using p-values in order to emphasize the significant outcomes.
Results: The patients involved in the study were 120 with 58.3% being males and 83.4% of the cases being within the age group of 5-18years (p<0.05). Abdominal pain was the most consistent symptom, present in all patients, followed by vomiting (75%) and fever (66.7%). Diagnostic accuracy was high for ultrasound (83%) and CT scans (66.7%). Laboratory markers such as elevated white blood cell counts (p<0.001) and C-reactive protein levels (p=0.015p) were significant indicators. Surgical findings revealed 66.7% of cases as simple appendicitis, while 33.3% were complicated (perforated or gangrenous). Post-operative complications included wound infections (8.3%) and intra-abdominal abscesses (4.2%). The average hospital stay was significantly longer in cases with complications (p=0.020).
Conclusion: Acute appendicitis in children presents predominantly with abdominal pain, often accompanied by vomiting and fever. Early diagnosis using clinical evaluation, imaging, and laboratory markers significantly reduces complications. Surgical management, particularly in uncomplicated cases, results in favourable outcomes. These findings underscore the importance of timely recognition and intervention in improving paediatric appendicitis outcomes.
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All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Muhammad Jehangir Khan
Assistant Professor, Department of Paediatric Surgery, Khalifa Gulnawaz Teaching Hospital, Bannu Medical College, Bannu, Pakistan