WOFAPS 2025 8th World Congress of Pediatric Surgery

Sello Machaea, Vincent Adeniyi

Walter Sisulu University

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Background

Appendicitis remains one of the most common surgical emergencies worldwide with a lifetime risk of 8.6% in males and 6.7% in females. The incidence rate is on the decline in high-income countries compared to low to medium-income countries, but remains stagnant in patients aged 0-4 years. In South Africa, where access to free health care is limited and most of the inhabitants are using public healthcare, a huge disparity exists in the presentation and outcome of appendicitis between the public and private sectors. Patients in the private sector have been shown to present early and with far fewer complications in comparison to those in the public sector.

Method

Retrospective cross-sectional study in three tertiary hospitals managing paediatric appendicitis.

Results

1520 patients were included in this study. Only 8 (0.5%) of the patients had a normal appendix with an even distribution between male and female and a mean age of 7.8 years. Only 1 of the 8 had undergone laparoscopic appendectomy due to the low number of laparoscopic appendectomies performed during this period. 75.5% of the patients presented with perforated appendicitis (grade 3,4 and 5 as per AAST grading).

Conclusion

The negative appendectomy rate is remarkably low in our setting compared to the 9.5% globally. This is eclipsed by the high number of patients presenting with complicated/perforated appendicitis. Delayed health seeking behaviour may attribute to these high numbers along with limited resources at referral centres