Determinants of the Sub-Types of Appendicitis and Postoperative Outcomes in Children: A Single Institution Experience

Authors

DOI:

https://doi.org/10.60787/tnhj.v24i2.811

Keywords:

abscess, outcome, fever, acute appendicitis, complicated appendicitis

Abstract

Background: The diagnosis of appendicitis has remained clinical. Available scoring systems do not differentiate the sub-types of the diagnoses and prognosticate the outcome. This study assessed the determinants of the sub-types of appendicitis and post-operative outcome.

Method: A retrospective study of all cases of appendectomies in children aged 1 -18 years, from January 2012 to December 2020. Data was collected in a proforma, analysed with SPSS and presented in tables.

Result: There are 100 cases of appendicitis with 57% males and 43% females. The mean age was 12.4(+3.35) years. The symptom onset- presentation interval ranged from 6 hours to 6years (median 5.5 days). Commonest symptoms were right iliac fossa pain - 80%, vomiting - 58%, fever – 52%, nausea – 39%, and anorexia - 35%. Commonest diagnosis and procedure were acute appendicitis-59% and emergency appendectomy-71.4%, respectively. The median presentation-surgery interval was 23hours. Complication rate was 18% with SSI accounting for 11%. There is a relationship between absence of fever and simple appendicitis (P < .001). There is also a relationship between absence fever and absence of post-op complications (P = .019). However, absence of fever is not a determinant of the sub-diagnosis of appendicitis or post-operative complication. Symptom duration of >48hrs is a determinant of post-operative complication (OR 18.4, P = 0.013, CI = 1.84 – 184.5).

Conclusion: Normal temperature may suggest a simple appendicitis. Symptoms duration of >48hrs has at least 18-fold chance of post-operative complications.

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Author Biographies

Ekwunife O, Nnamdi Azikiwe University Awka

Department of Sugery, Reader

Ugwu JO, Nnamdi Azikiwe University Awka

Department of Surgery, Reader

Maduba CC, Alex Ekwueme Federal University Teaching Hospital Abakaliki

Department of Surgery, Chief Consultant

Nnadozie UU, Alex Ekwueme Federal University Teaching Hospital Abakaliki

Department of Surgery, Professor

Ugwunne CA, Nnamdi Azikiwe University Teaching Hospital Nnewi

Department of Surgery, Consultant

Obiechina SO, Nnamdi Azikiwe University Teaching Hospital Nnewi

Department of Surgery, Consultant

Ezidiegwu US, Nnamdi Azikiwe University Teaching Hospital Nnewi

Department of Surgery, Consultant

Nwankwo EU, Nnamdi Azikiwe University Awka

Department of Surgery, Lecturer

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Published

2024-06-10

How to Cite

Modekwe, V., Ekwunife, O., Ugwu, J. O., Maduba, C. C., Nnadozie, U. U., Ugwunne, C. A., … Nwankwo, E. U. (2024). Determinants of the Sub-Types of Appendicitis and Postoperative Outcomes in Children: A Single Institution Experience. The Nigerian Health Journal, 24(2), 1275 – 1282. https://doi.org/10.60787/tnhj.v24i2.811
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