Introduction: Acute appendicitis (AA) is the most frequent surgical condition of the abdomen during childhood. Its clinical presentation in children under 5 may be atypical and thus causes a delay in diagnosis, which ...Introduction: Acute appendicitis (AA) is the most frequent surgical condition of the abdomen during childhood. Its clinical presentation in children under 5 may be atypical and thus causes a delay in diagnosis, which often leads to complications such as perforation and peritonitis. Patients with unperforated AA at hospital admission may have their surgery postponed up to 24 hours while antibiotics are initiated without significant increase in complications, instead of undergoing immediate surgery. Immediate surgery to prevent complications has been questioned. Delaying surgery in patients admitted to hospital with AA has not increased the risk of perforation. Objective: To determine the impact of timing of surgery of patients with AA admitted to our Pediatric Surgery Ward of the Sorocaba Hospital Complex of the Medical Science and Health Faculty (CHS-PUC/SP) on the rate of complications (perforation, peritoneal drainage and infection of the surgical wound). Methods: We reviewed the records of 195 children aged 4 to 12 years, admitted between 2010 and 2014. They were separated in 2 groups according to timing of surgery under 7 hours (group A) and 7 to 24 hours (group B) and had their rate of complications (infection of the surgical wound, drainage and perforation (grade IV) assessed. Results: Ninety-seven children underwent surgery less than 7 hours after admission (group A) and 98 children were operated between 7 and 24 hours after admission (group B). Groups A and B had no significant difference regarding the rates of wound infection (p = 0.2277), peritoneal drain insertion (p = 0.4085) or perforation (p = 0.7125). Conclusions: In our study, timing of surgery for AA had no impact on the occurrence of complications, such as infection of the surgical wound, peritoneal drainage or perforation.展开更多
目的:为了避免小儿阑尾脓肿手术及伤口换药的痛苦。方法:本组32例,采用 B 超引导下经皮穿刺抽脓治疗阑尾脓肿20例,经直肠脓肿穿刺抽脓1例,开腹引流2例,与同期行抗生素保守治疗的9例阑尾脓肿相比较。结果:经 B 超引导下穿刺抽脓治疗的21...目的:为了避免小儿阑尾脓肿手术及伤口换药的痛苦。方法:本组32例,采用 B 超引导下经皮穿刺抽脓治疗阑尾脓肿20例,经直肠脓肿穿刺抽脓1例,开腹引流2例,与同期行抗生素保守治疗的9例阑尾脓肿相比较。结果:经 B 超引导下穿刺抽脓治疗的21例阑尾脓肿,比用抗生素保守治疗的9例阑尾脓肿,腹痛消失时间减少5.2天,腹部压痛消失时间减少7.1天,退烧时间减少4.9天,住院时间减少3.3天。结论:B 超引导下经皮穿刺抽脓治疗阑尾脓肿有见效快、简便、安全和创伤小的优点。展开更多
文摘Introduction: Acute appendicitis (AA) is the most frequent surgical condition of the abdomen during childhood. Its clinical presentation in children under 5 may be atypical and thus causes a delay in diagnosis, which often leads to complications such as perforation and peritonitis. Patients with unperforated AA at hospital admission may have their surgery postponed up to 24 hours while antibiotics are initiated without significant increase in complications, instead of undergoing immediate surgery. Immediate surgery to prevent complications has been questioned. Delaying surgery in patients admitted to hospital with AA has not increased the risk of perforation. Objective: To determine the impact of timing of surgery of patients with AA admitted to our Pediatric Surgery Ward of the Sorocaba Hospital Complex of the Medical Science and Health Faculty (CHS-PUC/SP) on the rate of complications (perforation, peritoneal drainage and infection of the surgical wound). Methods: We reviewed the records of 195 children aged 4 to 12 years, admitted between 2010 and 2014. They were separated in 2 groups according to timing of surgery under 7 hours (group A) and 7 to 24 hours (group B) and had their rate of complications (infection of the surgical wound, drainage and perforation (grade IV) assessed. Results: Ninety-seven children underwent surgery less than 7 hours after admission (group A) and 98 children were operated between 7 and 24 hours after admission (group B). Groups A and B had no significant difference regarding the rates of wound infection (p = 0.2277), peritoneal drain insertion (p = 0.4085) or perforation (p = 0.7125). Conclusions: In our study, timing of surgery for AA had no impact on the occurrence of complications, such as infection of the surgical wound, peritoneal drainage or perforation.
文摘目的:为了避免小儿阑尾脓肿手术及伤口换药的痛苦。方法:本组32例,采用 B 超引导下经皮穿刺抽脓治疗阑尾脓肿20例,经直肠脓肿穿刺抽脓1例,开腹引流2例,与同期行抗生素保守治疗的9例阑尾脓肿相比较。结果:经 B 超引导下穿刺抽脓治疗的21例阑尾脓肿,比用抗生素保守治疗的9例阑尾脓肿,腹痛消失时间减少5.2天,腹部压痛消失时间减少7.1天,退烧时间减少4.9天,住院时间减少3.3天。结论:B 超引导下经皮穿刺抽脓治疗阑尾脓肿有见效快、简便、安全和创伤小的优点。
