Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children

Abstract

Background Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months. Methods The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. The medical records including laboratory data, computed tomography scans, pathology reports and operative notes were reviewed. Results The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses, as well as postoperative complications were observed between the two groups. Conclusions The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.

Seasonal Variation in Cases of Acute Appendicitis

“…Moreover, our data suggested a moderate positive correlation between the mean temperature and incidence. Our findings are in line with other studies which addressed this issue in Canada, the United States, South Korea, Iran, Italy, Taiwan, Pakistan, Finland, China, and the United Kingdom [3,5,[8][9][10][11][12][13].…”

“…In a study conducted on pediatric age group in Taiwan, it was noted that the percentage of appendicitis cases with fecoliths in summer was lower than other seasons. This was attributed to lymphoid hyperplasia which may be associated with the outbreak of enterovirus during this time of the year [ 9 ]. Zhang et al proposed that pediatric appendicitis cases were associated with higher temperatures, lower humidity, and less sunshine [ 12 ].…”

Perforated Appendicitis During a Pandemic: The Downstream Effect of COVID-19 in Children

“…Their comparison group was limited to the same time period in a previous year. Acute appendicitis is known to have seasonal and geographical differences 12,13 . Therefore, we compared our pandemic months with several months pre-pandemic as well as the same period the year prior to eliminate these confounders.…”