Acute appendicitis - One of the causes of peritonitis in newborn - A case report with literature review
DOI:
https://doi.org/10.12775/JEHS.2023.29.01.008Keywords
acute appendicitis, newborn, infant, child, pregnancy, peritonitis, abdominal pain, surgeryAbstract
INTRODUCTION. Acute appendicitis is the most common reason for abdominal surgery in children however in newborn and infants it’s casuistics. It is also the most common surgical emergency in pregnancy. Right lower abdominal pain, abdominal stiffness, and periabdominal pain radiating to the right lower abdomen are the best signs to diagnose acute appendicitis in adults. Absence Or attenuation of intestinal murmurs, positive sternal muscle signs, positive blunt signs, and positive Rovsing's Sign are the most reliable signs for the diagnosis of acute appendicitis in children.
PURPOSE. The aim of the study is to show diagnostic difficulties of acute appendicitis in newborns and infants. It is one of the main differential diagnoses of unclear abdominal conditions. The smaller the child, the less characteristic the symptoms.
A CASE REPORT. The study analyzes a male newborn born in the 37th week of pregnancy by caesarean section. Prenatal and family history of siblings' illnesses. In whom, on the 11th day of life, symptoms of food intolerance were found, green deposits were noticed in the stomach probe, and the presence of blood in the stool. Intraoperatively, gangrenous perforated appendix with diffuse peritonitis was found.
Acute appendicitis is rarely considered in newborns and infants as the etiological factor of acute peritonitis. However, the presented patient with a genetic defect.
CONCLUSION. Acute appendicitis is a common phenomenon in childhood, but this diagnosis is rarely considered in the differential diagnosis of acute abdomen in the neonatal period, is more common in premature babies. The clinical picture of neonatal acute appendicitis is unspecific and may lead to delayed diagnosis and misdiagnosis of necrotizing enterocolitis, which is a much more common condition in the neonatal period. We would like to present the diagnostic difficulties, course of treatment, and complications associated with neonatal appendicitis.
References
Matthew J Snyder , Marjorie Guthrie , Stephen Cagle Acute Appendicitis: Efficient Diagnosis and Management PMID: 30215950
Sahm M, Koch A, Schmidt U, et al. Akute Appendizitis - Klinische Versorgungsforschung zur aktuellen chirurgischen Therapie. Zentralbl Chir. 2013;138:270–277.
Buckius MT, McGrath B, Monk J, Grim R, Bell T, Ahuja V. Changing epidemiology of acute appendicitis in the United States: study period 1993-2008. J Surg Res. 2012;175:185–190.
Addiss DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol. 1990;132:910–925.
Golz RA, Flum DR, Sanchez SE, Liu XH, Donovan C, Drake FT. Geographic association between incidence of acute appendicitis and socioeconomic status. JAMA Surg. 2020;155(4):330–338. doi:10.1001/jamasurg.2019.6030.
Carr NJ. The pathology of acute appendicitis. Ann Diagn Pathol. 2000;4(1):46–58. doi:10.1016/S1092-9134(00)90011-X.
Wangensteen OH, Dennis C. EXPERIMENTAL PROOF OF THE OBSTRUCTIVE ORIGIN OF APPENDICITIS IN MAN. Ann Surg. 1939;110(4):629–647. doi:10.1097/00000658-193910000-00011.
Cervellin G, Mora R, Ticinesi A, et al. Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5,340 cases. Ann Transl Med. 2016;4:362.
Ilves I. Seasonal variations of acute appendicitis and nonspecific abdominal pain in Finland. WJG. 2014;20:4037.
Glass, C. C., & Rangel, S. J. (2016). Overview and diagnosis of acute appendicitis in children. Seminars in Pediatric Surgery, 25(4), 198–203. doi:10.1053/j.sempedsurg.2016.05.001
Schwartz KL, Gilad E, Sigalet D, Yu W, Wong AL. Neonatal acute appendicitis: A proposed algorithm for timely diagnosis. J Pediatr Surg. 2011;46:2060–4.
Drapala B, Trognon B, Canarelli JP, Tamboura Tientcheu A, Bensatti L, Razarimanantsoa L, et al. Neonatal appendicitis. Arch Pediatr. 2000;7:896–7.
Jancelewicz T, Kim G, Miniati D. Neonatal appendicitis: A new look at an old zebra. J Pediatr Surg. 2008;43:e1–5.
Stiefel D, Stallmach T, Sacher P. Acute appendicitis in neonates: Complication or morbus sui generis? Pediatr Surg Int. 1998;14:122–3.
Rassi, R., Muse, F., & Cuestas, E. (2019). Apendicitis aguda en niños menores de 4 años:Un dilema diagnóstico. Revista de La Facultad de Ciencias Médicas de Córdoba, 76(3), 180. doi:10.31053/1853.0605.v76.n3.23661
Almaramhy, H. H. (2017). Acute appendicitis in young children less than 5 years: review article. Italian Journal of Pediatrics, 43(1). doi:10.1186/s13052-017-0335-2
Swenson, D. W., Ayyala, R. S., Sams, C., & Lee, E. Y. (2018). Practical Imaging Strategies for Acute Appendicitis in Children. American Journal of Roentgenology, 1–9. doi:10.2214/ajr.18.19778
Schwartz, K. L., Gilad, E., Sigalet, D., Yu, W., & Wong, A. L. (2011). Neonatal acute appendicitis: a proposed algorithm for timely diagnosis. Journal of Pediatric Surgery, 46(11), 2060–2064. doi:10.1016/j.jpedsurg.2011.07.018
Khan, R., Menon, P., & Rao, K. L. N. (2010). Beware of neonatal appendicitis. Journal of Indian Association of Pediatric Surgeons, 15(2), 67. doi:10.4103/0971-9261.70646
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Copyright (c) 2023 Anna Olszanicka, Kacper Kołodziejczyk, Justyna Branewska, Barbara Ostrowska, Mikołaj Matysek, Jan Imioło, Anna Maciąg, Rafał Niemiec, Izabela Hop, Adam Galas
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