Ezmary Azimi MD, Mohammad Rafi Fazli MD, FACS, Neil Price MBChB, FRACS, Hania Wahidi MD
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引用次数: 0
Abstract
Background
Acute appendicitis is the most common aetiology of acute abdomen in children. Our aim is to describe the accuracy of diagnosis, and complications in a limited resources setting in children between 5 and 14 years old at the only tertiary referral hospital in the West region of Afghanistan.
Methods
A retrospective study for a period of 1 year (21 March 2015–20 March 2016). Data was collected from patients' files. Data were analysed by epi info 7.
Results
We identified 774 children who had appendectomies at Herat Regional Hospital during the study period with complete records available for analysis. The median age was 11 years [5–14]. The rate of positive appendectomy was 87%. 72% of appendectomies were done within 24 h of the onset of symptoms. Of 675 positive appendectomies, the most common clinical features were migratory abdominal pain (90%), nausea/vomiting (80%), RLQ tenderness (90%), and rebound tenderness (81%). Among the 99 negative appendectomies, the most common signs and symptoms were anorexia 68%, nausea/vomiting 59%, RLQ tenderness 79%, and rebound tenderness 43%. 98% of positive and 71% of negative appendectomies had elevated WBC count. Post appendectomy complications occurred in 9% of our patients mostly commonly intra-abdominal abscesses (5%).
Conclusion
Although the diagnosis of acute appendicitis is challenging in children and may involve sophisticated imaging techniques, in many settings these are unavailable. Classical manifestations such as migratory abdominal pain, abdominal tenderness, nausea, and simple lab tests play a crucial role in the diagnosis of acute appendicitis in low resource environments.
期刊介绍:
ANZ Journal of Surgery is published by Wiley on behalf of the Royal Australasian College of Surgeons to provide a medium for the publication of peer-reviewed original contributions related to clinical practice and/or research in all fields of surgery and related disciplines. It also provides a programme of continuing education for surgeons. All articles are peer-reviewed by at least two researchers expert in the field of the submitted paper.