Acute Appendicitisi in Pre-school Age Group

Kyung, K W; Koo, J H; Jung, D Y; Chang, J K

Abstract

A retrospective study was made on 57 cases of acute appendicitis in pre-school children under the age of seven years, who were treated during the period of 7 years from January,1987 to December, 1994. The results were as follows: For better analysis, we separated our patients into two groups, that is simple(suppurative appendicitis) group and complicated(gangrenous, perforated, periappendiceal abscess) group. 1) The incidence of acute appendicitis in pre-school children was 2.45% out of the total cases of appendicitis operated during the same period. 2) Male to female ratio was 2.8:1. 3) The youngest case was a 20 month old female. 4) 15 cases(28%) composed the simple group and 42 cases(72%) the complicated group. 5) The average interval between the onset of symptoms and the first interview by a Doctor was 0.97 day in simple and 2.1 days in complicated group. 6) The average interval between the onset of symptoms and the beginning of operation was 1.00 day in simple and 3.24 days in complicated group. 7) The most common symptom and sign of acute appendicitis were right lower quadrant abdominal pain and tenderness. Diffuse tenderness, rigidity,decreased bowel sound, and abdominal distension were more common in the complicated group. 8) Leukocytosis(10,000/mm3{ over) was found in 93.8% of simple, and 92.7% of complicated group. Leukocytosis over 15,000/mm3{ was found in 50.0% of simple group and 75.6% of complicated group. 9) Location of appendix was right lower quadrant in 49 cases,intrapelvic in 6 cases,and mid abdomen in 2 cases. 10) The postoperative complications occurred mainly in the complicated group and they were intestinal obstruction,wound infection,and intraabdominal abscess in order of frequency. Mortality rate was zero. 11) The rate of perforation under 4 year old was 100% and the younger,the higher perforation rate. 12) The average hospital duration was 9.8 days, 6.0 days in simple and 11.6 days in complicated group. 13) 35 cases(61%) were transferred from local clinics and 30 cases(85%) of them were classified to complicated group.