Conservative Treatment in Uncomplicated Appendicitis in Pediatrics at Tertiary Center Hospital
Background: Acute appendicitis is common in children, with appendectomy as the traditional treatment. Scoring systems like Alvarado and RIPASA help assess patient eligibility for conservative treatment, considering symptoms and additional factors like age, sex, and symptom duration. Recent studies r...
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| Format: | Article |
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South Valley University, Faculty of Medicine
2024-07-01
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| Series: | SVU - International Journal of Medical Sciences |
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| Online Access: | https://svuijm.journals.ekb.eg/article_383862.html |
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| author | Essam Alaa Al-Din Abd Al-Aziz Mohamed Abd – Al Shafy Ahmed Abd Almonem Elrashidy Nezar Abdelraouf Abo Halawa |
| author_facet | Essam Alaa Al-Din Abd Al-Aziz Mohamed Abd – Al Shafy Ahmed Abd Almonem Elrashidy Nezar Abdelraouf Abo Halawa |
| author_sort | Essam Alaa Al-Din Abd Al-Aziz |
| collection | DOAJ |
| description | Background: Acute appendicitis is common in children, with appendectomy as the traditional treatment. Scoring systems like Alvarado and RIPASA help assess patient eligibility for conservative treatment, considering symptoms and additional factors like age, sex, and symptom duration. Recent studies recommend antibiotics as an initial treatment for uncomplicated cases, to avoiding surgery in many cases.
Objectives: To evaluate non-operative management of appendicitis in pediatrics.
Patients and methods: A cohort study done at pediatric surgery unit in Qena University Hospitals from Sep 2022 to Mar 2023 included children with acute uncomplicated appendicitis. Diagnosis was based on the available scores for diagnosis of appendicitis. Conservative management involved diagnosis antibiotics, clinical evaluation and radiological evaluation.
Results: Thirty patients were included in this study. Common symptoms: abdominal pain (100%), appetite loss (56.67%), nausea/vomiting/diarrhea (60%). All diagnosed with appendicitis. Pediatric Appendicitis Score: tenderness (80%), leukocytosis (90%), cough/percussion (66.67%), nausea/vomiting (60%), anorexia (83.33%), pain migration (86.67%), median score 8. IV antibiotics: median 1.925 g (range: 0.35-5.9 g). Outcomes: 90% symptom resolution, median 4-day hospital stay (range: 2-7 days), 6.67% recurrence, 6.67% appendectomy. Post-intervention, significant improvement in signs/symptoms, ultrasonography, CRP; WBC count improved variably.
Conclusion: Conservative treatment for uncomplicated pediatric appendicitis is safe, successful (90% cure rate), cost-effective, and efficient with short hospital stays. Although it has a high success rate but may require a few patients undergo appendectomy. |
| format | Article |
| id | doaj-art-aa1551ab253645229578e38c1d859562 |
| institution | Kabale University |
| issn | 2735-427X 2636-3402 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | South Valley University, Faculty of Medicine |
| record_format | Article |
| series | SVU - International Journal of Medical Sciences |
| spelling | doaj-art-aa1551ab253645229578e38c1d8595622025-02-06T09:57:43ZengSouth Valley University, Faculty of MedicineSVU - International Journal of Medical Sciences2735-427X2636-34022024-07-0172594602https://doi.org/10.21608/svuijm.2023.236865.1702Conservative Treatment in Uncomplicated Appendicitis in Pediatrics at Tertiary Center HospitalEssam Alaa Al-Din Abd Al-Aziz Mohamed Abd – Al ShafyAhmed Abd Almonem ElrashidyNezar Abdelraouf Abo HalawaBackground: Acute appendicitis is common in children, with appendectomy as the traditional treatment. Scoring systems like Alvarado and RIPASA help assess patient eligibility for conservative treatment, considering symptoms and additional factors like age, sex, and symptom duration. Recent studies recommend antibiotics as an initial treatment for uncomplicated cases, to avoiding surgery in many cases. Objectives: To evaluate non-operative management of appendicitis in pediatrics. Patients and methods: A cohort study done at pediatric surgery unit in Qena University Hospitals from Sep 2022 to Mar 2023 included children with acute uncomplicated appendicitis. Diagnosis was based on the available scores for diagnosis of appendicitis. Conservative management involved diagnosis antibiotics, clinical evaluation and radiological evaluation. Results: Thirty patients were included in this study. Common symptoms: abdominal pain (100%), appetite loss (56.67%), nausea/vomiting/diarrhea (60%). All diagnosed with appendicitis. Pediatric Appendicitis Score: tenderness (80%), leukocytosis (90%), cough/percussion (66.67%), nausea/vomiting (60%), anorexia (83.33%), pain migration (86.67%), median score 8. IV antibiotics: median 1.925 g (range: 0.35-5.9 g). Outcomes: 90% symptom resolution, median 4-day hospital stay (range: 2-7 days), 6.67% recurrence, 6.67% appendectomy. Post-intervention, significant improvement in signs/symptoms, ultrasonography, CRP; WBC count improved variably. Conclusion: Conservative treatment for uncomplicated pediatric appendicitis is safe, successful (90% cure rate), cost-effective, and efficient with short hospital stays. Although it has a high success rate but may require a few patients undergo appendectomy.https://svuijm.journals.ekb.eg/article_383862.htmlconservative treatment uncomplicatedappendicitis pediatrics |
| spellingShingle | Essam Alaa Al-Din Abd Al-Aziz Mohamed Abd – Al Shafy Ahmed Abd Almonem Elrashidy Nezar Abdelraouf Abo Halawa Conservative Treatment in Uncomplicated Appendicitis in Pediatrics at Tertiary Center Hospital SVU - International Journal of Medical Sciences conservative treatment uncomplicated appendicitis pediatrics |
| title | Conservative Treatment in Uncomplicated Appendicitis in Pediatrics at Tertiary Center Hospital |
| title_full | Conservative Treatment in Uncomplicated Appendicitis in Pediatrics at Tertiary Center Hospital |
| title_fullStr | Conservative Treatment in Uncomplicated Appendicitis in Pediatrics at Tertiary Center Hospital |
| title_full_unstemmed | Conservative Treatment in Uncomplicated Appendicitis in Pediatrics at Tertiary Center Hospital |
| title_short | Conservative Treatment in Uncomplicated Appendicitis in Pediatrics at Tertiary Center Hospital |
| title_sort | conservative treatment in uncomplicated appendicitis in pediatrics at tertiary center hospital |
| topic | conservative treatment uncomplicated appendicitis pediatrics |
| url | https://svuijm.journals.ekb.eg/article_383862.html |
| work_keys_str_mv | AT essamalaaaldinabdalaziz conservativetreatmentinuncomplicatedappendicitisinpediatricsattertiarycenterhospital AT mohamedabdalshafy conservativetreatmentinuncomplicatedappendicitisinpediatricsattertiarycenterhospital AT ahmedabdalmonemelrashidy conservativetreatmentinuncomplicatedappendicitisinpediatricsattertiarycenterhospital AT nezarabdelraoufabohalawa conservativetreatmentinuncomplicatedappendicitisinpediatricsattertiarycenterhospital |