Acute Appendicitis in Children: Postoperative Evolution According to Risk Factors;
Single-Centre Retrospective Review

Background: Abdominal pain is a frequent complaint in Pediatric Primary Care as well as in the Emergency Department. Acute appendicitis (AA) is the main etiology of surgical abdominal pain in children.

Objectives: Our aim is to describe and analyze the clinical characteristics of our patients who have undergone surgery on suspicion of AA. Secondly, to describe AA evolution according to some prognosis factors.

Methods: Retrospective, descriptive and analytical study through review of electronic clinical records. Patients from 0 to 14 years old who have undergone surgery for suspicion of AA, are included. Study period: 8 months. Setting: tertiary hospital.

Results: Sample size = 96. Median age = 10`8 years. Male sex: 64.6%. The most frequent symptoms in our study are: pain in low right quadrant (79.2%), nausea/vomiting (72.9%), fever (32.3%) and hyporexia (22.9%). Preferred diagnostic method is ultrasound (performed in 91.6%). Most common intraoperative findings are: phlegmonous AA (37.5%), gangrenous AA (40.6%), plastron (10.4%). 37.5% appendices are retrocecal. We have analyzed the incidence of complications (days of total admission, admission to pediatric intensive care, need for a central catheter or parenteral nutrition, need of surgical reintervention) in children under 4 years of age, in gangrenous AA, in those with ultrasonography data suggesting complicated AA, and those with increased CRP.

Conclusions: Acute appendicitis is the main surgical diagnosis of abdominal pain in pediatric age. According to literature, some factors are known to be related to worse prognosis, such as: age under 4 years old, gangrenous or perforate AA and CRP increase. However, we have not found a statistically significant association in this respect.