Jehangir Ahmed.
Presentation of acute appendicitis in children.
Pak J Med Health Sci Jan ;4(4):315-8.

Objectives: To identify the presenting symptoms, signs and outcome of management in children with appendicitis Study Design: Retrospective descriptive study Place & Duration of Study: Pediatric Surgery Department, Bolan Medical Complex Hospital, Quetta, From January 2009 to June 2010. Methods: All those patients with diagnosis of Appendicitis were included in this study. A detailed history, clinical examination and relevant investigations were done. Operative findings were recorded. The final diagnosis was determined by operating surgeon’s impressions and by histopathology. Results: A total of 79 children under the age of 14 years with a diagnosis of acute appendicitis between January 2009 and June 2010 were reviewed. The average age of the patients was 10.13 years. The most common presenting complaints were pain right lower quadrant 84.84%, anorexia, 72%, nausea/vomiting 67%.The mean duration of pain was 35.92 hours. Maximum tenderness over right lower quadrant and rigidity were important diagnostic sings. Psoas and Rovsing signs could be elicited in up to 1/3 of patients; however presence of these signs was strongly associated with appendicitis. Seven patients presented with generalized peritonitis. At surgery 70/79(88.60%) patients had appendicitis, of these 14(20%) had perforated appendix. Post operative complications included wound infection and dehiscence of wound in 27% patients. Conclusion: Appendicitis is a common surgical condition; a careful history and physical examination are key to diagnosing appendicitis in children. Delay in diagnosis is associated with complications.

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