1. Kim Vanderlinden, Toon De Backer Dienst kinderchirurgie, UZ Brussel
A single-centre, 10-year retrospective study of appendectomy in children, with emphasis on the postoperative complications.
Kim Vanderlinden, Toon De Backer
Dienst kinderchirurgie, UZ Brussel
BESPGHAN – BELAPS congress, Mechelen, 22th October 2016

2. Aim of the study To analyse retrospectively our patient series
Focus on postoperative complications following appendectomy
Kim Vanderlinden, Toon De Backer

3. Method Retrospective Single institution: UZ Brussel
10-year consecutive series ( )
Exclusion of incidental and interval appendectomies
Patients from 0 to 15 years
median 10 years
61% male - 39% female
Kim Vanderlinden, Toon De Backer

4. Number of patients
Kim Vanderlinden, Toon De Backer

5. Age 0 – 5 years: 59 patients 6 – 10 years: 246 patients 11 - 15 years:
Kim Vanderlinden, Toon De Backer

6. Technique for appendectomy
Kim Vanderlinden, Toon De Backer

7. Technique for appendectomy: evolution
Kim Vanderlinden, Toon De Backer

8. Postoperative complications following appendectomy
Intra-abdominal abscess
Surgical wound infection
Rehospitalization for pain and/or fever
Mechanical ileus (adhesions)
Perforation of appendiceal stump
Kim Vanderlinden, Toon De Backer

9. Group I: uncomplicated appendicitis
Inflamed appendix
Hyperemia and edema
Fibrinous exudate
Kim Vanderlinden, Toon De Backer

10. Group II: complicated appendicitis
Classified intraoperatively as having
gangrenous appendicitis (necrosis)
perforated appendicitis with an abscess
perforated appendicitis with peritonitis (regional or diffuse)
Kim Vanderlinden, Toon De Backer

11. Results Complicated appendicitis Necrosis Abscess Peritonitis
Kim Vanderlinden, Toon De Backer

12. Results
Kim Vanderlinden, Toon De Backer

13. Complications in group I (uncomplicated appendicitis): 3,1%
Kim Vanderlinden, Toon De Backer

14. Complications in group II (complicated appendicitis): 32,5%
Kim Vanderlinden, Toon De Backer

15. Age
Serious complications occurred more frequently in the younger children
Kim Vanderlinden, Toon De Backer

16. Age 0 – 5 years: 59 patients 6 – 10 years: 246 patients 11 - 15 years:
Kim Vanderlinden, Toon De Backer

17. Age 0 – 5 years: 59 patients 6 – 10 years: 246 patients 11 - 15 years:
24 uncomplicated (41%)
35 complicated (59%)
198 uncomplicated (80%)
48 complicated (20%)
227 uncomplicated (84%)
43 complicated (16%)
Kim Vanderlinden, Toon De Backer

18. Age
Kim Vanderlinden, Toon De Backer

19. Conclusion
Appendicitis in young children (< 6 years) is more frequently complicated at the moment of diagnosis/surgery - in comparison with older children
Serious complications occurred more frequently in the younger children
Kim Vanderlinden, Toon De Backer

20. Conclusion Importance of high index of suspicion
recognize every appendicitis in the earliest stage of the disease
operate without delay
especially with the youngest children in mind
Kim Vanderlinden, Toon De Backer

21. The end
Questions?
Kim Vanderlinden, Toon De Backer