Evaluation of the Pediatric Acute Appendicitis

Purpose: We evaluated the demographic characteristics, clinical presentation, diagnostic clues, morbidity, and the final outcomes of acute appendicitis in kids. Methodology: All kids up to 14 years who were diagnosed and operated for acute appendicitis were included in the study. The diagnosis of acute appendicitis was established by clinical findings, laboratory tests and ultrasound findings, finally was confirmed by macroscopic inspection during surgery, and combined with the histopathological analysis. Results: Over a period of study (24 months), out of 98 kids, 61% were males and 39% were females. We observed 56% kids developed acute appendicitis at the age of (10-12) years. In this study, the common signs and symptoms at presentation are nausea/ vomiting (98%), anorexia (91%), right lower abdominal tenderness (78%), and vague abdominal pain (71%). Elevated WBC count (85%), Neutrophilia (84%), and urine ketones (78%) are the most common biomarkers related to pediatrics acute appendicitis. Positive ultrasound finding for appendicitis in n=57(58%). Prevalence of appendicoliths was 86.7%. Unnecessary appendicectomy rate was 8%. The most common morbidities are wound infection 53%, adhesive bowel obstruction= 21%, postoperative abdominal abscess= 14%, and wound dehiscence =12%. Conclusion: Vague abdominal pain, nausea, vomiting, and anorexia are the most frequent presenting clinical findings of acute appendicitis in kids. Right lower quadrant tenderness is the most important clinical parameter in diagnosis of kids with acute appendicitis. Elevated WBC count, neutrophilia, and urine ketones are the most supportive biomarkers related to pediatrics acute appendicitis. The most postoperative morbidities are the wound infection, adhesive bowel obstruction, postoperative abdominal abscess, and wound dehiscence.