背景技术急性阑尾炎(AA)是全球最常见的外科急症。疾病诊断延迟通常会导致严重的并发症,例如穿孔性阑尾炎(PA)和坏疽性阑尾炎(GA)。目的和目标本研究的目的是记录三级医疗保健中心儿科年龄组患者的临床病理结果。材料与方法本研究是对2022年1月至2022年12月接受急诊阑尾切除术的50例小儿阑尾炎患者的前瞻性观察研究。包括所有15岁以下诊断为AA的儿科患者。在研究之前,研究所获得了伦理许可,并且家长同意进行手术并纳入研究.经过适当的复苏,所有患者都接受了阑尾切除术,并将必要的标本送去进行组织学检查。根据组织病理学报告,所有患者分为四组:AA,PA,GA,和正常阑尾(NA)。结果50例患者中,33(66%)患者为男性,17(34%)患者为女性。患者的平均年龄为10.22±2.73岁。AA的平均年龄,PA,GA,NA患者为10.25±2.6岁,9.78±2.99年,10.00±4.6年,12.00±2.8年,分别。经组织病理学证实的AA患者入院时的平均症状持续时间为2.42±0.97天,GA患者4.67±2.1天,PA患者为2.8±0.83,和NA患者的一天。总体临床表现为36例(72%)患者的右髂窝(RIF)疼痛,31(62%)患者的疼痛迁移,37例(74%)患者厌食症,43例(86%)患者的恶心和呕吐,26例(52%)患者的发热,50例(100%)患者RIF压痛,39例(78%)患者出现反跳压痛,保护19名(38%)患者,9例(18%的患者)的腰大肌症状,19名(38%)患者出现了罗辛氏体征。在对送来的标本进行组织病理学检查时,在36名(72%)患者中发现了AA,在9名(18%)患者中发现了PA,在三名(6%)患者中发现了GA,在两名(4%)患者中发现NA。伤口感染是最常见的并发症,在五名(10%)患者中发现。AA的平均住院时间,PA,GA,NA为4.33±1.04天,9.56±4.2天,12.33±8.5天,3.50±0.71天,分别。结论阑尾疾病常见于青少年男性儿童。发烧,脱水,RIF和反弹压痛是临床上有意义的发现。诊断时症状的持续时间,阑尾切除术后并发症,住院时间与组织病理学结果显著相关。
Background Acute appendicitis (AA) is the most common surgical emergency worldwide. Delay in diagnosis of disease often leads to serious complications such as perforation appendicitis (PA) and gangrenous appendicitis (GA). Aims and objectives The purpose of the study is to document clinicopathological outcomes in pediatric age group patients in a tertiary health care center. Material and method This study was a prospective observation study of 50 patients with pediatric appendicitis who had undergone emergency appendectomy from January 2022 to December 2022. All pediatric patients below 15 years of age with a diagnosis of AA were included. Institute ethical permission was granted before the study, and parent consent was taken for the surgery and also for inclusion in the study. After proper resuscitation, all patients underwent appendectomy, and necessary specimens were sent for histological examination. Based on histopathology reports, all patients were classified into four groups: AA, PA, GA, and normal appendix (NA). Results Out of 50 patients, 33 (66%) patients were males and 17 (34%) patients were females. The mean age of the patients was 10.22 ± 2.73 years. The mean age of AA, PA, GA, and NA patients were 10.25 ± 2.6 years, 9.78 ± 2.99 years, 10.00 ± 4.6 years, and 12.00 ± 2.8 years, respectively. The mean duration of symptoms at the time of hospital admission was 2.42 ± 0.97 days for histopathologically proven AA patients, 4.67 ± 2.1 days for GA patients, 2.8 ± 0.83 for PA patients, and one day for NA patients. Overall clinical presentation was right iliac fossa (RIF) pain in 36 (72%) patients, migration of pain in 31 (62%) patients, anorexia in 37 (74%) patients, nausea and vomiting in 43 (86%) patients fever in 26 (52%) patients, RIF tenderness in 50 (100%) patients, rebound tenderness in 39 (78%) patients, guarding in 19 (38%) patients, Psoas\'s sign in nine (18% patients), and Rovsing\'s sign in 19 (38%) patients. On histopathological examination of the sent specimen, AA was found in 36 (72%) patients, PA was found in nine (18%) patients, GA was found in three (6%) patients, and NA was found in two (4%) patients. Wound infection was the most common complication and was found in five (10%) patients. The average duration of hospital stay for AA, PA, GA, and NA was 4.33 ± 1.04 days, 9.56 ± 4.2 days, 12.33 ± 8.5 days, and 3.50 ± 0.71 days, respectively. Conclusion The appendicular disease is common in teenage male children. Fever, dehydration, and rebound tenderness at the RIF are clinically significant findings. Duration of symptoms at the time of diagnosis, post-appendectomy complication, and duration of hospital stay significantly correlated with histopathological findings.