The influence of delay on perforation in childhood appendicitis. A retrospective analysis of 58 cases

OBJECTIVE: Appendicitis is the most common non-traumatic surgical abdominal disorder in children aged 2-years or older. It is generally believed that delay in diagnosis and surgery of acute appendicitis is associated with a more advanced stage of disease and a higher morbidity. The aim of this retrospective study was to document the clinical features of acute appendicitis (AA), and to describe the factors associated with appendiceal perforation (AP) among children.

METHODS: This study included 58 patients who underwent emergency appendectomy during the period January 1998 through to December 2002, Suleyman Demirel University Hospital, Isparta, Turkey. They were proven to have AA by operative findings and pathology reports, and were further included in this study.

RESULTS: The preadmission delay which is mostly due to parents and post admission delay which is due to physicians other than pediatric surgeons were found as highly associative factors for AP. Perforation is unlikely in AA patients in the first 48-hours of the abdominal pain.

CONCLUSION: Associated symptoms of the abdominal pain may cause delay to diagnosis. The children who have abdominal pain and associated symptoms should be consulted with a pediatric surgeon.