The importance of timely detection and management in neonatal appendicitis

Abstract

The clinical presentation of cute appendicitis is rarely encountered in neonatology. When it does occur, it is thought to be due to prematurity or develops secondary to coexisting diseases. We present a case of appendicitis in a 10-day-old Middle-Eastern girl, who was born at term and who had no underlying conditions that are typically associated with neonatal appendicitis. This case highlights that certain causes and clinical signs are unreliable when coming to a working diagnosis of neonatal appendicitis, and that regardless of the cause, timely detection and management are necessary in achieving surgical success.

A case of Amyand's hernia in a preterm infant

“…4 It has, however, been described to occur on the left in various clinical situations where the appendix may be found on the left side (situs inversus, intestinal malrotation, a long appendix or a very mobile caecum). 12,11 The pathophysiology of Amyand's hernia and its relationship with appendicitis are not fully known. Whilst some authors suggest that it is an incidental finding, others attribute it to incarceration leading to decreased blood supply and subsequent necrosis.…”

“…Hirschsprung's disease, cystic fibrosis, meconium plug syndrome, necrotizing enterocolitis and vascular insufficiency (cardiac or respiratory disease) are documented risk factors for appendicitis. 12,13 The incidence Summary: The findings of a normal or inflamed appendix in a hernia sac is a rare finding intraoperatively. It is referred to as an Amyand's hernia, named after Claudius Amyand who first described it in 1735.…”

Idiopathic Perforated Appendicitis in Neonates and Infants

“…Vascular insufficiency secondary to cardiac defect or perinatal hypoxia is believed to be a cause of perforated appendicitis; this theory is the most likely cause in our first and third cases 17 . Approximately 60% of neonatal appendicitis occurs in premature babies 18,19 .…”

“…The symptoms of appendicitis in infants is non-specific, including irritability and abdominal distension and/or fever; therefore, abdominal radiography should be obtained, which is of benefit when it shows pneumoperitoneum and an abdominal ultrasonography is the best assessment for evaluating infants with these symptom [18][19][20] .…”

Perforated appendicitis in a preterm neonate: A case report with literature review

“…[6,7] Our female newborn was extremely premature at 27-4/7 weeks' gestational age, and presented with perforated appendicitis by DOL 30, with no other comorbidities. We conducted a literature search for neonatal and infant appendicitis and appendectomy on PubMed and Google Scholar, with no restrictions on publication date.…”