Appendicitis in children: Current therapeutic recommendations

Neilson, Ian R.; Laberge, Jean-Martin; Nguyen, L.T.; Moir, Christopher R.; Doody, Daniel P.; Sonnino, Roberta; Youssef, Sami; Guttman, Frank M.

doi:10.1016/0022-3468(90)90742-r

Cited by 97 publications

(44 citation statements)

References 14 publications

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“…Our approach used observation (mean 14 h of observation) and total inpatient stay durations (mean of 2.5 days after negative appendectomy, 2.1 days after simple appendicitis and 7.8 days after perforated appendicitis) were similar to those reported in the literature [7,8]. The perforation rate seen in our series was similar to other published series but the negative appendectomy rate was lower ( Table 4).…”

Section: Discussionsupporting

confidence: 84%

Do not rush into operating and just observe actively if you are not sure about the diagnosis of appendicitis

et al. 2009

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Both the features and results and the complication rates and costs of the group operated on after observation were the same as the directly operated on group. However, patients undergoing a negative appendectomy stayed as inpatients longer than only observation patients with higher treatment charges. We could therefore decrease the negative appendectomy rate, the associated cost and duration of hospitalization without causing extra complications if we observe and investigate patients with right lower quadrant pain with a doubtful diagnosis and did not operate on them directly.

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Section: Discussionsupporting

confidence: 84%

Do not rush into operating and just observe actively if you are not sure about the diagnosis of appendicitis

et al. 2009

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“…Laparoscopy and ultrasound have selectively been used with good results [4,13,14,15,16,17,18,19]. In our unit, emphasis is placed on a careful and unhurried physical examination.…”

Section: Discussionmentioning

confidence: 99%

Acute appendicitis in preschool-age children

2004

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“…However, most of these reports predate the era of current antimicrobial therapy, which has led to decreased rates of wound infections. Many studies in the 80s and 90s reported low rates of infection using primary closure (PC), suggesting that such management might be safely and successfully used [4,[7][8][9][10][11][12][13][14][15][16][17][18].…”

Section: Background/purposementioning

confidence: 99%

Primary versus delayed wound closure in complicated appendicitis: an international systematic review and meta-analysis

Henry¹,

Moss²

2005

Ped Surgery Int

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The purpose of this study was to determine, by means of a systematic review, whether the method of wound closure in complicated appendicitis affects the incidence of wound infection. A comprehensive literature search of multiple databases including MEDLINE (1980-2003), was performed, using the Cochrane search strategy, for articles on wound closure and complicated appendicitis. Clinical trials examining the method of wound closure were selected for systematic review and all quasi-randomized and randomized trials underwent meta-analysis. Failure to close the wound as planned in delayed closure (DC) was considered indicative of a wound infection. Purulent drainage requiring wound opening indicated an infection in the wounds closed primarily. Six randomized trials were considered adequate for meta-analysis. None independently showed a statistically significant difference in the risk of developing a wound infection with primary closure (PC). When pooled data were subjected to meta-analysis, PC achieved a statistically significant reduction in the relative risk of treatment failure and did not lead to an increase in wound infections. Primary closure does not increase the risk of developing a wound infection after operation for perforated appendicitis. Given the lack of benefit of DC, and the less traumatic, less painful, and less costly nature of PC; primary closure is a safe and practical treatment option.

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Appendicitis in children: Current therapeutic recommendations

Cited by 97 publications

References 14 publications

Do not rush into operating and just observe actively if you are not sure about the diagnosis of appendicitis

Do not rush into operating and just observe actively if you are not sure about the diagnosis of appendicitis

Acute appendicitis in preschool-age children

Primary versus delayed wound closure in complicated appendicitis: an international systematic review and meta-analysis

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