EN
TÜRKÇE
Poster - 94
Prognostic value of the histopathology of the appendix for children with recurrent appendicitis
Evita Brigere 1, Astra Zviedre 2, Arnis Eņģelis 3, Aigars Petersons 4, Vilnis Titāns 5
1 Riga Stradins University & Children's Clinical University Hospital, Department of Paediatrics
2 Riga Stradins University, Department of Paediatric Surgery, Outpatient Clinic
3 Riga Stradins University & Children's Clinical University Hospital, Department of Paediatric Surgery
4 Riga Stradins University, Department of Paediatric Surgery
5 Outpatient Clinic "LaTi & Co" Ltd, Riga, Latvia
Aim.To determine prognostic value of the histopathology of the appendix for children with recurrent appendicitis (RA).
Methods.A retrospective cohort study was conducted for patients (7-18 years) with RA in paediatric tertiary care institution (January 2019 - December 2022). All patients underwent appendectomy (interval or urgent) and were divided in three groups - uncomplicated RA (21), complicated RA (28) and chronic RA (14) based on histopathological analysis of the appendix. Data analysis of duration of symptoms, Alvarado score (AS), serum C-reactive protein (CRP), interleukin-6 (IL-6), white blood cells count (WBC), abdominal ultrasound (US) among patients were obtained during the first episode of uncomplicated acute appendicitis (AA). The analysis of the data was processed by IBM SPSS 29 (p<0.05). Ethical approval was given by the local institutional review board.
Results.The study included 63 patients with the mean age of 12.4 (SD2.6), of them 37 (58.7%) boys. A relapse during a 6-month period after the first AA episode was observed for 27 patients (42.9%). Most interval appendectomies were seen in chronic RA group (62,5%) but more than half (59,6%) of urgent appendectomies in complicated RA group. The median of WBC for uncomplicated RA and chronic was 15.64x103/µL (IQR=2.89) and 12.75x103/µL (IQR=4.12). Patients with chronic RA had significantly lower cut-off values of WBC compared to uncomplicated RA (H(2)=15.369; p=0.045). Patients with complicated RA had a tendency towards statistical significance: they were younger than patients with uncomplicated RA (H(2)=5.171, p=0.075). There were no statistically significant differences among the study groups for the following parameters: duration of symptoms, AS, CRP, IL-6, US.
Conclusion.Children with normal or slightly elevated WBC receiving conservative treatment of AA could be predicted to receive interval appendectomy in a case of RA.