PERFORATED APPENDICITIS IN CHILDREN: THE RISK FACTORS FOR THE DEVELOPMENT OF COMPLICATIONS

Abstract

Major complications such as wound infection, intestinal obstruction, intraabdominal abscess formation, and delayed ileus may occur after the operation in patients with perforated appendicitis. We aimed to research the risk factors which may effect the developing of these postoperative complications. We have evaluated the potential risk factors (such as delay between the first sign of the disease and the administration time, the age, white blood cell count, the use of abdominal drain, the severity of the disease) and mortality rate in 180 patients operated for perforated appendicitis in our institution between March 1983 and February 2000. Of 180 patients, there was 132 boys and 48 girls. The mean age was 11. Postoperative complication occurred in 14.4% of patients. The most frequent complication was wound infection (65.3%) followed by intestinal obstruction (19.2%). When we compare the potential risk factors in patients; being younger or older than 8 was not a significant factor (p>0.05) but the delaying more than 48h after the first sign of the disease was a significant risk factors (p<0.05) for developing of postoperative complications. The amount of white blood cell less or more than 10.000/mm3 was found not to be significant (p>0.05) as well as the use of abdominal drains (p=0.001). However, the severity of the perforated appendicitis was a significant factor for the developing of complication (p=0.003). We lost a child (0.5%) with generalized peritonitis who has been administered in the hospital 10 days after the first sign of the disease while he was in a septic status. The most important risk factors for the developing postoperative complications was the late administration to hospital and the presence of intense exudes in the abdomen. There was no effects of drains for diminishing the postoperative abdominal complications.