Risk factors of delayed diagnosis of acute appendicitis in children at Zagazig University Hospitals

Document Type : Original Article

Authors

1 Pediatric Surgery Department, Faculty of Medicine, Zagazig university, Zagazig, Egypt

2 Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt

3 Pediatric Surgery Department, Faculty of medicine, Zagazig University, Zagazig, Egypt

4 General Surgery Department, Faculty of Medicine, Zagazig university, Zagazig, Egypt

Abstract

Background: Acute appendicitis is most common surgical cause of acute abdomen in children but its diagnosis presents significant difficulties and delayed diagnosis result in complications. The present work aims to avoid the risk factors of delayed diagnosis of acute appendicitis there for to achieve early diagnosis of acute appendicitis to avoid complications.
Methods: This study was carried out in emergency unit of pediatric surgery Department, Zagazig University Hospitals, during the period from February 2019 to august 2019. The study is Prospective cross sectional study included 62 patients with acute appendicitis under go appendectomy with equal number in each group. The patients were classified into 2 groups, according to time of onset of abdominal pain before the appendectomy confirmed bu pelvi abdominal ultrasound and operative finding : 24 hours or more (delayed group) and less than 24 hours (not delayed group).
Results: we compare between two groups including history taking, ultrasound, CT abdomen done for 4 patients. prior local clinic. fever, diarrhea, CRP,PAS and elevated TLC were significantly associated with delayed group (with p value 0.005 for diarrhea, p value 0.00 for fever P value for CRP 0.034).
Conclusion: We suggest that child with abdominal pain associated with fever and anorexia and elevated TLC should be evaluated by surgeons especially if pain progressively increased to avoid delay in diagnosis of acute appendicitis.

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