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Abstract
Aim Acute appendicitis in newborns is rare and can be fatal. The incidence of the disease is reported as 0.04%-0.2%. Because neonatal appendicitis does not have any specific clinical findings, it is considered as an exclusion diagnosis. Appendix perforation is a common complication in diagnosed patients with a high mortality rate and its treatment is surgery. In our study, our neonatal appendicitis case, who came to our emergency department on the 8th postnatal day with bilious vomiting, circulatory dysfunction, and shock, is presented with a literature review.
Material and Method A female newborn with Down syndrome was admitted to our emergency department with the complaint of fekaloid vomiting and deterioration in her condition (figure 1). It was learned that she was brought to hospital because she had abdominal distension and intermittent vomiting for about 2 days, and there was no urine output for the last 24 hours. While no distal air passage was observed in the patient‘s standing direct abdominal radiograph, an abdominal computed tomography scan was performed upon the preliminary diagnosis of ileus, and the diagnosis was confirmed.
The patient‘s fecaloid vomiting at the emergency department admission and perforated appendicitis seen during the operation.
Results The patient, who was taken into operation after consulting with the pediatric surgeon, was evaluated as perforated neonatal appendicitis (figure 1).
Conclusions Recent publications regarding neonatal appendicitis are generally written on isolated cases. Large case series can rarely be collected. A total of 141 cases were reported in the literature between 1905 and 2000. Although neonatal appendicitis occurs at the same rate in premature and term babies, the mortality rate was reported to be 28% in a study published in 2003. Diagnostic tools are also limited in neonatal appendicitis. X-ray gives clear information after perforation. Computed tomography can provide specific findings in patients. In the management, classical laparotomy and peritoneal lavage are performed. The most important management issue in these patients is early diagnosis and treatment with the least amount of invasive procedures.