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Acute Appendicitis in Children in Kumasi, Ghana:Macroscopic Findings at Laparotomy
Abstract
Background A lot has been written about acute appendicitis in children in the developed countries but very little is written about this condition among children in the sub Saharan region. It used to be said that acute appendicitis is rare in Africa but this is no longer the case. We are unable to find, in the literature, any reference to acute appendicitis in children in Ghana. We, therefore, reviewed our experience with this pathology, especially the operative findings, in children using the Kumasi metropolitan area.
Patients and Methods Ninety-six children admitted and treated for acute appendicitis from January 2001 to December 2003 were considered. The macroscopic findings at laparotomy were meticulously noted down and these form the basis for the analysis. Appendicectomy was carried out in all the 96 children.
Results In all there were 67 boys and 29 girls, a boy to girl ratio of 2.2:1. the ages ranged from 1.8 years to 14.0 years with a mean age of 10.1 ± 2.8 years. Macroscopically, simple acute appendicitis (uncomplicated) was found in 13 (13.5%) and obstructive appendicitis (complicated) in 83 (86.5%) children. Postoperative complications consisted of superficial surgical site infection in 4, deep surgical site infection in 3 and incomplete wound dehiscence in 2. there was one death in the series- a mortality rate of 1.0%.
Conclusion Acute appendicitis is no more a rarity in the sub-saharan setting as more and more people live affluently and adopt the western style of life. As a result of prehospital delay and also delays in diagnosis, complicated appendicitis was common among our group of patients.
Key Words: Acute appendicitis, children, macroscopy, complications
African Journal of Paediatric Surgery Vol.(1)1 2004: 6-10
Patients and Methods Ninety-six children admitted and treated for acute appendicitis from January 2001 to December 2003 were considered. The macroscopic findings at laparotomy were meticulously noted down and these form the basis for the analysis. Appendicectomy was carried out in all the 96 children.
Results In all there were 67 boys and 29 girls, a boy to girl ratio of 2.2:1. the ages ranged from 1.8 years to 14.0 years with a mean age of 10.1 ± 2.8 years. Macroscopically, simple acute appendicitis (uncomplicated) was found in 13 (13.5%) and obstructive appendicitis (complicated) in 83 (86.5%) children. Postoperative complications consisted of superficial surgical site infection in 4, deep surgical site infection in 3 and incomplete wound dehiscence in 2. there was one death in the series- a mortality rate of 1.0%.
Conclusion Acute appendicitis is no more a rarity in the sub-saharan setting as more and more people live affluently and adopt the western style of life. As a result of prehospital delay and also delays in diagnosis, complicated appendicitis was common among our group of patients.
Key Words: Acute appendicitis, children, macroscopy, complications
African Journal of Paediatric Surgery Vol.(1)1 2004: 6-10
