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Pediatric Surgery International

, Volume 17, Issue 2–3, pp 125–128 | Cite as

Acute appendicitis: the continuing role for active observation

  • P. Bachoo
  • A. A. Mahomed
  • G. K. Ninan
  • G. G. Youngson
ORIGINAL ARTICLE

Abstract

We present the results of a 6-year review of appendicitis. In the event of diagnostic doubt, a policy of active observation was instituted. This review endorses the validity of such a policy, indicating that it does not expose patients to increased morbidity. Data were collected prospectively over a 6-year period on 1,479 children admitted with suspected acute appendicitis (AA); 1,028 (69.5%) were discharged with a diagnosis of non-specific abdominal pain after a mean observation period of 2.5 days, whilst in the remaining 451 a clinical diagnosis of AA was confirmed. The male-to-female ratio was equal, with no difference in the mean age of males (11 years) or females (12 years); 95% of patients were over the age of 5 years. In 324 (72%) cases surgery was performed on the day of admission, whilst in the remaining 126 (28%) it was deferred for 1 to 6 days because the clinical diagnosis of AA remained doubtful. The mean hospital stay was 4 days (range 1 – 32). Analysis of the histological reports of all 451 cases confirmed a positive predictive value for clinical assessment alone of 97.9% and a normal appendicectomy rate of 2.6%. No mortality was observed; surgical morbidity was recorded at 6% with no correlation between post-operative morbidity and timing of surgery evident (Spearmans correlation coefficient = −0.079, p=0.9). Active observation for suspected AA thus remains a valid technique for achieving an accurate diagnosis and successful outcome.

Keywords Active observation Appendicitis 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • P. Bachoo
    • 1
  • A. A. Mahomed
    • 1
  • G. K. Ninan
    • 1
  • G. G. Youngson
    • 1
  1. 1.Department of Surgical Paediatrics, Royal Aberdeen Children's Hospital, Cornhill Road, Aberdeen AB25 2ZG, UKGB

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