WOFAPS 2025 8th World Congress of Pediatric Surgery

Mehmet Sarıkaya ¹, Fatma Özcan Sıkı ¹, Fadime Ovalı ², Hüsamettin Vatansev ², İlhan Çiftçi ¹

¹ Selcuk University Faculty of Medicine, Department of Pediatric Surgery
² Selcuk University Faculty of Medicine Department of Biochemistry

Purpose:
Trimethylamine N-oxide (TMAO), a metabolite derived from gut microbiota, has been linked to various chronic inflammatory conditions. However, its potential role in acute inflammation, such as pediatric acute appendicitis, remains unclear. This study aimed to evaluate the utility of TMAO as a novel biomarker in the diagnosis and severity assessment of pediatric acute appendicitis.

Method:
In this prospective study, 137 pediatric patients who underwent surgery for suspected acute appendicitis were included. Based on histopathological findings, patients were categorized into negative, non-complicated, and complicated appendicitis groups. Serum and urinary TMAO levels were measured using LC-MS/MS. Statistical analyses included ANOVA, Kruskal-Wallis, and bootstrap post-hoc tests.

Results:
Urinary TMAO levels were significantly higher in the non-complicated appendicitis group compared to the complicated group (p=0.046), whereas no significant differences were observed in serum TMAO levels among the groups (p=0.292). Traditional inflammatory markers supported the diagnosis but were not the primary focus of this study.

Conclusion:
Urinary TMAO may serve as a promising novel biomarker in pediatric acute appendicitis, particularly for differentiating non-complicated from complicated cases. To confirm its clinical utility, larger, multicentre studies including diet, microbiota and kidney assessments are required.