Intraluminal appendiceal fluid is a predictive factor for recurrent appendicitis after initial successful non-operative management of uncomplicated appendicitis in pediatric patients

J Pediatr Surg. 2014 Jul;49(7):1116-21. doi: 10.1016/j.jpedsurg.2014.01.003. Epub 2014 Jan 28.

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.

Keywords: Intraluminal appendiceal fluid; Pediatric; Predictive factor; Recurrent appendicitis.

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / therapeutic use
  • Appendectomy
  • Appendicitis / diagnosis
  • Appendicitis / drug therapy
  • Appendicitis / physiopathology*
  • Appendicitis / surgery
  • Appendix / diagnostic imaging
  • Body Fluids / physiology*
  • Cefoperazone / therapeutic use
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Male
  • Recurrence
  • Risk Factors
  • Tomography, X-Ray Computed
  • Ultrasonography

Substances

  • Anti-Bacterial Agents
  • Cefoperazone