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A Clinical Study on Acute Appendicitis in Children.

Journal of the Korean Pediatric Society 1985;28(12):1207-1215.
Published online December 31, 1985.
A Clinical Study on Acute Appendicitis in Children.
Choong Hun Kim, Un Ki Yoon, Soon Ok Byun, Ji Sub Oh
Department of Pediatrics, Wallace Memorial Baptist Hospital, Pusan, Korea
소아 급성충수염에 관한 임상적 고찰
김충현, 윤운기, 변순옥, 오지섭
왈레스기념 침례회병원 소아과
Abstract
This study is a clinical analysis of 225 cases of acute appendicitis in children under the age of 15 which were confirmed by operation at the department of surgery of WMBH during the past 7 year period from January 1978 to December 1984. The following results were obtained: 1)The incidence of appendicitis is rare under the age of 6 and increased gradually after then. The highest incidence was the group over the age of 10. Seasonal incidence was relatively increased in summer and spring. Sex ratio of male to female was 71.6 : 1. 2)The mean duration from onset to admission was 1.9 days in the unperforated group and2.6 days in the perforated group. The percentage of perforation in 24 hours was 23.1% and that after 24 hours was 76.3%. This difference was statistically significant (p value <0.005) 3)Overall perforation rate was 16.9%. Especially under the age of 6, the incidence of perforation was 28.9% and that of unperforation was 6.9%. This difference was statistically significant (p<0.005). 4)The most common clinical symptom was right lower quadrant pain in the unperforated, group and anorexia and fever in the perforated group. The most frequent physical sign in acute appendicitis was tenderness and rebound tenderness on RLQ. It was especially characterized by tenderness over the whole abdomen, abdominal rigidity and rectal tenderness in the perforated group. 5)The incidence of leukocyte count below 10,000/mm was 23.1%. The rate is 26.2% in unperforated group and 7.9% in perforated group. This revealed a significant difference (p<0.01). The increase in neutrophils above 75% was 80.4%. That in the unperforated, group was 78. 1%. Most of perforated group has an increase in neutrophils. 6) The incidence of complication was 2.1% in the unperforated group and 36.8% in the perforated group. This difference was statistically significant (p<0.005). The most common complication was wound infection (3.1%). 7)The average hospital stay was 6.7 days. There was significant difference between 5.8 days in the unperforated group and 11.1 days in the perforated group(p<0.005). 8) The greatest number of cases (145 cases, 64.4%) were admitted via the emergeency room. Among them, 53.1% was transferred to the surgery department from pediatric department. Eighty cases(35.6%) were admitted via out patient clinic. Among them, 61.2% were transferred to surgical department from pediatric department.
Key Words: Acute appendicitis


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