Appendicitis in children: An increasing
health scourge in a developing country

Osarumwense David Osifo¹, Scott. O. Ogiemwonyi²

ABSTRACT

Objectives: The incidence of appendicitis is rising in developing countries. We aimed to determine the effects of late referrals and wrong treatment on the outcome of appendicitis in Benin City, Nigerian.

Methodology: A retrospective analysis of all children treated for appendicitis at the University of Benin Teaching Hospital, between January 1998 and December 2007. Pre/post operative morbidities, length of hospitalization, cost of treatment and mortality were compared between children who presented early, within 24 hours of first episode of symptoms, and those who presented later.

Results: A total of 481 children aged between 2 and 16 (mean 9.7 ± 2.8) years, comprising 265 males and 216 females with male/female ratio1.2:1 had appendicectomy which accounted for 5.7% of total pediatric operations and 47.5% of pediatric abdominal operations. Only 206 (42.8%) children presented during the first episode of symptoms and in clinically stable state while 275 (57.2%) were referred after wrong diagnosis and treatment by general practitioners which resulted in different complications ranging from appendix abscess 60 (12.5%), appendix mass 54 (11.2%), perforated appendix 47 (9.8%), gangrenous appendix 41 (8.5%) and peritonitis 34 (7.0%). These influenced post operative outcome with wound infection recorded in 91 (18.9%), wound break down 35 (7.3%), septicemia 31 (6.4%), pelvic abscess 13 (2.7%) and death 1 (0.2%). These were not recorded among those who presented early who also had significantly lower duration of hospitalization and cost of treatment (P<0.0001).

Conclusion: Late referral due to low index of suspicion was rampant which significantly increased associated morbidities and mortality among children managed with appendicitis.

KEYWORDS: Appendicitis, Children, Incidence, Outcome, Developing country.

Pak J Med Sci    April - June 2009 (Part-II)    Vol. 25 No. 3    490-495

How to cite this article:

Osifo OD, Ogiemwonyi SO. Appendicitis in children: An increasing health scourge in a developing country. Pak J Med Sci 2009;25(3): 490-495.

---

1. Osarumwense David Osifo, MBBS, FWACS
2. Scott. O. Ogiemwonyi, WASC, MBBS
1,2: Paediatric Surgery Unit,
Dept. of Surgery,
University of Benin Teaching Hospital,
Benin City, Nigeria.

Correspondence

Osifo O.D,
E-mail: Leadekso@yahoo.com

* Received for Publication: Oct. 22, 2008
* Revision Received: May 13, 2009
* Revision Accepted: May 15, 2009

---

HOME   |   SEARCH   |   CURRENT ISSUE   |   PAST ISSUES

Professional Medical Publications
Room No. 522, 5th Floor, Panorama Centre
Building No. 2, P.O. Box 8766, Saddar, Karachi - Pakistan.
Phones : 5688791, 5689285 Fax : 5689860
pjms@