Clinical Analysis Of 318 Cases Of Appendiceal Abscess In Children

Objective: Analysis the clinical data of children with appendicitis of 10,256 cases during the period 1980-2009 and discuss the related issues combined with literature,in order to facilitate a full understanding of appendicitis and appendiceal abscess in children , understand epidemiology,guide clinical diagnosis and treatment and provide a basis for further research.Methods: Design questionnaire for the clinical data of pediatric appendicitis in children. Statistics the clinical data of 6607 cases of pediatric appendicitis in children on the 1990-2009 period in detail,include sex, age, hospitalization time, duration, length of stay, clinical symptoms, signs, body temperature, blood leukocyte and neutrophil counts, abdominal B-results, pathological classification, preoperative diagnosis, intraoperative appendix, postoperative diagnosis , peritoneal fluid situation, peritoneal washing, postoperative drainage situation, pus, postoperative complications and antibiotic use. Cases during the period 1980-1989, due to incomplete information, only summary statistics and were no deaths. Analysis the data of 318 cases of pediatric appendicular abscess in children on the 1990-2009 period.Results:1.In 6607 cases of pediatric patients with appendicitis, appendiceal abscess in children were 318 cases, accounting for 4.8% over the same period of appendicitis in children.2.In 318 cases of appendiceal abscess, 184 cases were male and 134 cases were female. The ratio of male to female is 1.37: 1.The cases were aged 9 months to 14 years and the mean age was 5.4 years. Cases under 3 years were accounted for 74 .3.The major clinical symptoms were fever in 271 cases (85.2%), abdominal pain in 296 cases (93.1%), among 81 patients with right lower abdominal pain (27.4%), right lower abdominal pain in 33 patients with metastatic (11.1%), umbilical pain in 66 patients (22.3 %), upper abdominal pain in 7 cases (2.4%), all abdominal pain in 12 patients (4.1%), abdominal pain in 83 patients with multiple (28%), lower abdominal pain in 14 cases (4.7%), gastrointestinal symptoms in 307 cases (93.1%), including nausea, vomiting, 257 cases (83.7%), diarrhea in 45 patients (14.7%), abdominal distention in 4 cases (1.3%), constipation in 1 case (0.3%).4.Main signs were: 296 cases of abdominal tenderness (93.1%) of which 225 cases of right lower quadrant tenderness (76.0%), whole abdominal tenderness in 52 cases (17.6%), umbilical tenderness in 9 cases (3.0%), abdominal tenderness in 7 cases (2.4 %); in the upper abdominal tenderness in 1 case (0.3%),right upper quadrant tenderness in 2 cases (0.7%), 206 cases of muscular tension (64.8%) and abdominal mass in 17 cases (5.3%).5.Blood leukocyte count :10-20×109 between the 192 cases, 20×109 of more than 72 cases and normal in 54 cases. Neutrophils of the 161 cases were more than 80%.6.B-ultrasonic examination: 247 cases of abdominal B-admission for the first time the results were as follows: right lower abdominal inflammation, the liquid component containing 158 patients (64%), right lower abdominal inflammation, its non-liquid components within the 51 cases (20.6%), appendix abscess in 5 patients (2.0%), right lower quadrant clutter echo in 20 cases (8.1%) and normal in 13 cases (5.3%).7.Treatment: 86 cases of non-surgical treatment, surgical treatment of 232 cases, 191 routine appendectomy and peritoneal washing, and 41 cases of simple abdominal drainage. Non-surgical treatment group and the surgical treatment group, the average hospital stay was 8.9 days and 10.9 days, surgical resection group appendectomy group and simple peritoneal drainage group, the average hospital stay was 10.2 days and 12.8 days. 191 cases after a routine appendectomy abscess in 2 cases, 3 cases of intestinal obstruction. All patients were cured without one case of death.Conclusion: Appendiceal abscess in children is one of the complication with acute appendicitis in children after treatment of the delay.Early diagnosis and treatment of acute appendicitis is to reduce the incidence of appendiceal abscess in the key.Currently ongoing fixed right lower abdominal pain and right lower quadrant tenderness to children with acute appendicitis surgery pointer effectively reduce the incidence of complications.Diagnosis of appendiceal abscess in addition to clinical symptoms and signs should pay attention to the abdomen outside the B ultrasonic imaging.Treatment of appendiceal abscess in children should be the condition of patients choose the right treatment.Appendiceal abscess in infants and young children are advised early surgery.Whether or not surgery, the rational use of antibiotics that affect the prognosis of this disease an important factor.