Appendiceal Diseases in Children in a University Teaching Hospital in Southwest Nigeria

Abstract

Background: Appendicitis is common, with a lifetime occurrence of 7 per cent. It is an urgent surgical illness with a wide range of manifestations and extensive overlap with other clinical syndromes.

Objective: To examine the presentation, differential diagnoses and complications of appendiceal diseases.

Methods: An eight-year retrospective study (18 July 2016 - 18 August 2023) was carried out in a Nigerian Teaching Hospital. All cases of appendiceal diseases managed in children during the study were included. Case notes of patients who were managed from admission through surgical intervention, discharge from the hospital, and complete follow-up at the paediatric outpatient clinic were selected for data retrieval and further processing.

Results: Four hundred children with appendiceal diseases were seen during the study period. However, only 250 patients’ case records were studied. Out of the 250 children studied, 170 were males (68%), giving a male-to-female ratio of 2.1:1. The age range was one year to 15 years. Those aged 7-12 years were in the majority (175; 70%). Most of the children (80; 32%) presented late to the hospital with the presence of complications, which occurred more in those aged less than 7 years (150; 75%). The complications included a ruptured appendix with generalised peritonitis (40; 50%), localised peritonitis (18; 22.5%), appendiceal mass (16; 20%), and gangrene of the appendix (6; 7.5%).

Conclusion: Acute appendicitis is one of the causes of acute abdominal conditions in children. Delayed presentation is common. Complications at presentation were associated with young age and late presentation.