Perforated Acute Appendicitis in a Six-Day-Old Neonate: A Rare Differential Diagnosis of Neonatal Peritonitis

Nguyen, Thanh Xuan; Dang, Nhu Thanh; Phan, Hai Thanh; Pham, Nhu Hiep; Vu, Hoai Anh

doi:10.1159/000512425

Cited by 3 publications

(4 citation statements)

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“…With cross‐referencing, eight additional eligible articles were identified. In total, 131 articles were included in this systematic review 3,6,12–140 . Figure 1 provides the PRISMA flowchart.…”

Section: Resultsmentioning

confidence: 99%

“…In total, 131 articles were included in this systematic review. 3 , 6 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 ...…”

Section: Resultsmentioning

confidence: 99%

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Appendicitis and its associated mortality and morbidity in infants up to 3 months of age: A systematic review

The,

Derikx

et al. 2023

Health Science Reports

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Background and AimsAlthough appendicitis is rare in young infants, the reported mortality is high. Primary aim of this systematic review was to provide updated insights in the mortality and morbidity (postoperative complications, Clavien‐Dindo grades I–IV) of appendicitis in infants ≤3 months of age. Secondary aims comprised the evaluation of patient characteristics, diagnostic work‐up, treatment strategies, comorbidity, and factors associated with poor outcome.MethodsThis systematic review was reported according to the PRISMA statement with a search performed in Pubmed, Embase and Web of Science (up to September 5th 2022). Original articles (published in English ≥1980) reporting on infants ≤3 months of age with appendicitis were included. Both patients with abdominal appendicitis and herniated appendicitis (such as Amyand's hernia) were considered. Data were provided descriptively.ResultsIn total, 131 articles were included encompassing 242 cases after identification of 4294 records. Overall, 184 (76%) of the 242 patients had abdominal and 58 (24%) had herniated appendicitis. Two‐hundred (83%) of the patients were newborns (≤28 days) and 42 (17%) were infants between 29 days and ≤3 months of age. Either immediate, or after initial conservative treatment, 236 (98%) patients underwent surgical treatment. Some 168 (69%) patients had perforated appendicitis. Mortality was reported in 20 (8%) patients and morbidity in an additional 18 (8%). All fatal cases had abdominal appendicitis and fatal outcome was relatively more often reported in newborns, term patients, patients with relevant comorbidity, nonperforated appendicitis and those presented from home.ConclusionMortality was reported in 20 (8%) infants ≤3 months of age and additional morbidity in 18 (8%). All patients with fatal outcome had abdominal appendicitis. Several patient characteristics were relatively more often reported in infants with poor outcome and adequate monitoring, early recognition and prompt treatment may favour the outcome.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Appendicitis and its associated mortality and morbidity in infants up to 3 months of age: A systematic review

The,

Derikx

et al. 2023

Health Science Reports

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“…A non-complicated case of Amyand hernia may be asymptomatic or may present with nonspecific symptoms that mimic orchitis, testicular torsion, or enterocolitis (7). However, in cases of appendicitis the diagnosis of Amyand hernia is challenging and requires a high index of suspicion.…”

Section: Discussionmentioning

confidence: 99%

Perforated Appendix in Amyand Inguinal Hernia in a Neonate Presenting as Obstructed Oblique Inguinal Hernia: A Case Report and Review of Literature

Abdullateef,

Eid,

Aldaqaq

et al. 2023

Pediatric Sciences Journal

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An Amyand hernia is defined as when the appendix is trapped within the sac of an inguinal hernia through a patent vaginal process. It was first described by Claudius Amyand, in 1735 during an appendectomy of a perforated appendix inside a hernial sac of an 11-year old child. Amyand hernia rare, constituting less than 1% of inguinal hernias. Amyand hernia is 3 times more likely to be diagnosed in children compared to adults due to the patency of vaginal process. Appendicitis or its perforation in Amyand hernia, complicate 0.1% of cases. Other variants include the presence of ileum, caecum or both in addition to the appendix. Isolated acute appendicitis in neonates is extremely rare, with a high mortality rate, and higher among those within Amyand hernia up to 30%. Perforated appendix in Amyand hernia is difficult to diagnose, as its clinical picture is not specific. We report a neonate 26 days old with perforated appendix in an Amyand inguinal hernia who presented by a picture of obstructed oblique inguinal hernia.He underwent emergency open inguinal exploration, herniotomy and appendicectomy. Despite the high mortality rate of Amyand hernia due to be peritoneal spread of sepsis, the boy survived complication free. Perforated appendix in Amyand hernia is exceptionally rare, and can present in the early neonatal period, its diagnosis and outcome rely on high index of suspicion and prompt surgical intervention.

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“…Neonatal peritonitis may have a bacterial or chemical cause. The majority of cases of bacterial peritonitis in this age group can be attributed to Necrotizing Enterocolitis (NEC), complications of a bowel obstruction, or iatrogenic stomach or duodenum perforation [29]. Primary peritonitis remains a rare entity in the pediatric population and group A streptococcus (GAS) is a rather unusual cause [28].…”

Section: Discussionmentioning

confidence: 99%

Group A Streptococcus Infection in Neonatal Population: A Systematic Review of The Literature

Sokou,

Filippatos,

Daniil

et al. 2023

JCM

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(1) Background: The importance of group A streptococcus (GAS) infection severity has been recognized in children and adults. However, to our knowledge, there have been no systematic reviews or pooled assessments of the incidence and outcome of invasive GAS (iGAS) disease in neonates, a potentially high-risk population. Therefore, we performed a systematic review of available data regarding the risk factors, clinical presentation, and outcome of GAS infection in neonates. (2) Methods: An electronic search of the existing literature was carried out during the period July 2023–September 2023 in the PubMed and Scopus databases, considering studies referring to GAS infection in the neonatal population. (3) Results: Overall, 39 studies met all the inclusion criteria and were included in this review, evaluating data from 194 neonates. Unfortunately, there were a lot of missing data among the retrieved studies. Our systematic review highlighted the presence of differences with regards to clinical presentation, infection sites, and outcome of GAS invasive disease between neonates with early-onset (EOS) or late-onset sepsis (LOS). Common characteristics of EOS included respiratory distress, rapid deterioration, and high mortality rate irrespective of the infection site, while rash, gastrointestinal tract symptoms, and fever appeared to be the most frequent symptoms/clinical signs and manifestations of LOS disease. The management of severe invasive iGAS disease consists mainly of specific antimicrobial treatment as well as supportive care with fluids and electrolyte supplementation, minimizing or counteracting the effects of toxins. Furthermore, a mortality rate of approximately 14% was recorded for iGAS disease in the total of all studies’ neonates. (4) Conclusions: Although iGAS is a rare entity of neonatal infections, the potential severity of the disease and the rapid deterioration requires the development of quick analysis methods for the detection of GAS allowing the prompt diagnosis and administration of the indicated antibiotic treatment. Furthermore, given the exceptional risk for both the pregnant woman and the neonate, it is very important to raise awareness and create easily accessible guidelines that could facilitate the prevention and management of maternal as well as the subsequent neonatal severe iGAS disease.

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Perforated Acute Appendicitis in a Six-Day-Old Neonate: A Rare Differential Diagnosis of Neonatal Peritonitis

Cited by 3 publications

References 9 publications

Appendicitis and its associated mortality and morbidity in infants up to 3 months of age: A systematic review

Appendicitis and its associated mortality and morbidity in infants up to 3 months of age: A systematic review

Perforated Appendix in Amyand Inguinal Hernia in a Neonate Presenting as Obstructed Oblique Inguinal Hernia: A Case Report and Review of Literature

Group A Streptococcus Infection in Neonatal Population: A Systematic Review of The Literature

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