Yuhki Koike1, Keiichi Uchida2, Kohei Matsushita3, Kohei Otake2, Makoto Nakazawa3, Mikihiro Inoue2, Masato Kusunoki2, Yoshihide Tsukamoto3. 1. Department of Pediatric Surgery, National Mie Hospital, Mie, Japan; Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan. Electronic address: koikyon@clin.medic.mie-u.ac.jp. 2. Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan. 3. Department of Pediatric Surgery, National Mie Hospital, Mie, Japan.
Abstract
BACKGROUND: The risk factors for recurrent appendicitis in pediatric patients are unclear. This study aimed to identify the predictive factors for recurrent appendicitis in pediatric patients who initially underwent successful non-operative management of uncomplicated appendicitis. METHODS: Potential predictive factors for recurrent appendicitis in terms of clinical characteristics, laboratory data, and abdominal ultrasonography and computed tomography findings, were evaluated. RESULTS: This study included 125 patients who underwent initial successful non-operative management of appendicitis. The rate of recurrent appendicitis was 19.2%, and the mean time to recurrence was 12.6 months. Univariate analyses found that rebound tenderness, muscle guarding, appendicoliths, appendiceal diameter >9 mm, and intraluminal appendiceal fluid were associated with recurrent appendicitis. Multivariate analysis identified only intraluminal appendiceal fluid as an independent predictor of recurrent appendicitis. CONCLUSIONS: Intraluminal appendiceal fluid is a predictive factor for recurrent appendicitis after initial non-operative management. The results of this study provide valuable information that may help to determine the appropriate management during the first episode of appendicitis.
BACKGROUND: The risk factors for recurrent appendicitis in pediatric patients are unclear. This study aimed to identify the predictive factors for recurrent appendicitis in pediatric patients who initially underwent successful non-operative management of uncomplicated appendicitis. METHODS: Potential predictive factors for recurrent appendicitis in terms of clinical characteristics, laboratory data, and abdominal ultrasonography and computed tomography findings, were evaluated. RESULTS: This study included 125 patients who underwent initial successful non-operative management of appendicitis. The rate of recurrent appendicitis was 19.2%, and the mean time to recurrence was 12.6 months. Univariate analyses found that rebound tenderness, muscle guarding, appendicoliths, appendiceal diameter >9 mm, and intraluminal appendiceal fluid were associated with recurrent appendicitis. Multivariate analysis identified only intraluminal appendiceal fluid as an independent predictor of recurrent appendicitis. CONCLUSIONS:Intraluminal appendiceal fluid is a predictive factor for recurrent appendicitis after initial non-operative management. The results of this study provide valuable information that may help to determine the appropriate management during the first episode of appendicitis.
Authors: Nigel J Hall; Frances C Sherratt; Simon Eaton; Isabel Reading; Erin Walker; Maria Chorozoglou; Lucy Beasant; Wendy Wood; Michael Stanton; Harriet J Corbett; Dean Rex; Natalie Hutchings; Elizabeth Dixon; Simon Grist; William Van't Hoff; Esther Crawley; Jane Blazeby; Bridget Young Journal: Health Technol Assess Date: 2021-02 Impact factor: 4.014
Authors: Nigel J Hall; Simon Eaton; Olivier Abbo; Alexis P Arnaud; Marianne Beaudin; Mary Brindle; Andreana Bütter; Dafydd Davies; Tim Jancelewicz; Kathy Johnson; Richard Keijzer; Eveline Lapidus-Krol; Martin Offringa; Nelson Piché; Risto Rintala; Erik Skarsgard; Jan F Svensson; Wendy J Ungar; Tomas Wester; Andrew R Willan; Augusto Zani; Shawn D St Peter; Agostino Pierro Journal: BMJ Paediatr Open Date: 2017-05-18