The Presence but not the Location of an Appendicolith Affects the Success of Interval Appendectomy in Children with Ruptured Appendicitis  

作　　者：Iyore A. James Stephen Druhan Donna A. Caniano Gail E. Besner 

机构地区：[1]不详

出　　处：《Surgical Science》2011年第2期39-44,共6页外科学（英文）

摘　　要：Purpose: To determine whether the presence and/or location of an appendicolith can predict failure of initial non-operative management in children with ruptured appendicitis. Methods: A retrospective chart review of pediatric patients presenting with ruptured appendicitis was performed. Patients in whom the intent to treat was with initial non-operative management and interval appendectomy (IA) were selected (n = 117). One patient was excluded due to the presence of both intraluminal and extraluminal appendicoliths. Children who failed initial non-operative management were assigned to the “failure” group (n = 22). Children that improved and underwent elective IA were assigned to the “success” group (n = 94). Age, gender, duration of symptoms, presence of an appendicolith, appendicolith location (intraluminal/extraluminal), presence of a drainable abscess, and complications were reviewed. Results: There was an overall 18.8% failure rate for IA. Patients with an appendicolith had a 41.7% failure rate, and patients without an appendicolith had a 13% failure rate (p = 0.003). Patients with intraluminal or extraluminal appendicoliths each had a 41.7% failure rate. The presence or absence of a drainable in-tra-abdominal abscess did not affect the failure rate. Children in the failure group presented to the hospital earlier (6.57 ± 2.59 vs. 10.02 ± 7.21 days;p = 0.030). Conclusions: The presence of an appendicolith increases the likelihood of failure of initial non-operative management of ruptured appendicitis in children;however, the location of the appendicolith is not a predictor of failure.Purpose: To determine whether the presence and/or location of an appendicolith can predict failure of initial non-operative management in children with ruptured appendicitis. Methods: A retrospective chart review of pediatric patients presenting with ruptured appendicitis was performed. Patients in whom the intent to treat was with initial non-operative management and interval appendectomy (IA) were selected (n = 117). One patient was excluded due to the presence of both intraluminal and extraluminal appendicoliths. Children who failed initial non-operative management were assigned to the “failure” group (n = 22). Children that improved and underwent elective IA were assigned to the “success” group (n = 94). Age, gender, duration of symptoms, presence of an appendicolith, appendicolith location (intraluminal/extraluminal), presence of a drainable abscess, and complications were reviewed. Results: There was an overall 18.8% failure rate for IA. Patients with an appendicolith had a 41.7% failure rate, and patients without an appendicolith had a 13% failure rate (p = 0.003). Patients with intraluminal or extraluminal appendicoliths each had a 41.7% failure rate. The presence or absence of a drainable in-tra-abdominal abscess did not affect the failure rate. Children in the failure group presented to the hospital earlier (6.57 ± 2.59 vs. 10.02 ± 7.21 days;p = 0.030). Conclusions: The presence of an appendicolith increases the likelihood of failure of initial non-operative management of ruptured appendicitis in children;however, the location of the appendicolith is not a predictor of failure.

关 键 词：RUPTURED APPENDICITIS Failure NON-OPERATIVE Management APPENDICOLITH 

分 类 号：R73[医药卫生—肿瘤]