DOI: 10.36347/sjams.2021.v09i06.036

Pages: 1047-1052

Objectives: the purpose of our study was to report our experience at Queen Rania Al Abdullah Hospital for Children (QRHC) in the diagnosis and management of acute appendicitis regarding the outcome, complications and hospital stay. Method: A retrospective study was carried out at QRHC by reviewing the medical records of patients who were younger than 14 years that admitted to pediatric surgical ward in the period from Jan 2019 to Jan 2020 with a diagnosis of acute appendicitis. The study included 196 patients, 116 were males and 80 were females with a male to female ratio of 1.45:1. The ages of the patients ranged from 3 years to 14 years with the highest incidence between 10 -13 years. The duration of symptoms ranged from 8 hours to 1 week. The period of hospital stay ranged from 1 to 8 days with a median stay of 2 days. Results: all patients underwent appendectomy, 120 via open approach and 76 by laparoscopy with only 1.53% conversion rate to open (3 cases). 110 cases (56.1%) were non complicated appendicitis while the remaining 86 cases (43.9%) were complicated (perforated appendix), of those 20 cases were less than 5 years old. The rate of negative appendectomy (histopathological normal appendix) was 11.2% (22 cases). Fever was presented in 60 cases (30.6%) and leukocytosis was presented in 130 cases (66.3%).U/S was suggestive of acute appendicitis in 108 patients (55.1%) while the appendix was not visualized in the remaining 88 patients. CT scan was required in 40 patients (20.4%). The overall postoperative complications was 10.7% which occurred in 21 patients, 8 patients (4.1%) developed post-operative ileus , 6 patients (3.1%) complicated with wound infection, 4 cases (2%) developed intra-abdominal abscess and 3 patients (1.5%) had intestinal obstruction. Conclusion: Acute appendicitis is the commonest cause of abdominal surgical emergency in pediatrics and a common cause of misdiagnosed surgical emergency in children. Delayed diagnosis can result in ......