Korean J Pediatr Gastroenterol Nutr.  2010 Mar;13(1):30-35. 10.5223/kjpgn.2010.13.1.30.

Clinical Features of Infectious Ileocecitis in Children

• Lee TH
• Hong YR
• Yeon GM
• Lee JW
• Park JH

• KMID: 1459441
• DOI: http://doi.org/10.5223/kjpgn.2010.13.1.30

Abstract

PURPOSE
Infectious ileocecitis is an infection confined to the ileocecal area and one of the most common causes of pediatric abdominal pain. This study was performed to demonstrate the clinical features of infectious ileocecitis in children.
METHODS
The medical records and radiologic findings of 37 patients with ileocecitis diagnosed by ultrasonography and/or computed tomography, who were admitted to Pusan National University Hospital from January 2004 and July 2008, were reviewed retrospectively. Viral gastroenteritis and secondary ileocecitis were excluded.
RESULTS
The mean age of the patients was 4.8+/-3.4 years. One-half of the patients were preschool children. The chief complaint was abdominal pain (75.7%), diarrhea (10.8%), and vomiting (8.1%). Accompanying symptoms were fever (56.8%), vomiting (21.6%), and diarrhea (16.2%). The mean duration of abdominal pain, fever, diarrhea, and vomiting was 3.8+/-2.1, 3.0+/-1.9, 3.4+/-1.9, and 2.4+/-2.3 days, respectively. The frequency of diarrhea and vomiting was 5.8+/-2.2 and 4.0+/-2.8 per day, respectively. Diagnosis was made by abdominal ultrasonography in 22 patients (59.5%), abdominal CT in 2 patients (5.4%), and both modalities in 13 patients (35.1%). Besides the radiologic finding of thickening of the bowel wall, mesenteric lymphadenitis (59.5%), ascites (5.4%), and both mesenteric lymphadenitis and ascites (16.2%) were revealed. The mean duration of illness was 7.5+/-5.0 days. There were no specific laboratory findings, and culture studies with stool or blood were negative. All of the patients recovered completely without specific treatment.
CONCLUSION
Infectious ileocecitis has acute appendicitis-mimicking symptoms, but is self-limited within a few days, thus unnecessary treatment and work-up is avoided. However, distinguishing infectious ileocecitis from appendicitis, inflammatory bowel disease, and mesenteric lymphadenitis is important.

Keyword

Infectious ileocecitis; Children

MeSH Terms

Abdominal Pain
Appendicitis
Ascites
Child
Child, Preschool
Diarrhea
Fever
Gastroenteritis
Humans
Inflammatory Bowel Diseases
Medical Records
Mesenteric Lymphadenitis
Retrospective Studies
Vomiting

Figure

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  Fig. 1 Ultrasound imaging of ileocecitis. US scan shows thickening of the wall of the terminal ileum (short arrow) and cecum (long arrow). Image is obtained with a linear transducer in the right lower quadrant.

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