A Retrospective Analysis of Acute Appendicitis in Children Treated with Laparoscopic Appendectomies at a Single Center in Dubai, UAE

Abstract

<b><i>Background:</i></b> Appendicitis is one of the most common emergency conditions that occur in the pediatric population. The condition is usually suspected clinically, and the diagnosis is confirmed by radiological investigations such as ultrasound, CT scan, or MRI. This study was conducted to contribute to global databases by presenting data from the Middle East with an objective of identifying the clinical characteristics of children who were diagnosed with acute appendicitis and underwent laparoscopic appendectomy at a single pediatric surgery center in Dubai. <b><i>Methods:</i></b> A 2-year hospital-based retrospective cohort study was conducted at Mediclinic Parkview Hospital, Dubai, enrolling all patients younger than 14 years who were diagnosed with acute appendicitis and who underwent laparoscopic appendectomy. Demographic data, clinical presentation, laboratory, radiological and pathology findings, postoperative complications, and readmission rates were analyzed. <b><i>Results:</i></b> Fifty-six patients were operated on and enrolled in this study. All patients (56/56) presented with abdominal pain, while an associated fever was present in 44.6% (25/56); 78.5% (44/56) of the patients had nausea but 64.3% (36/56) had vomiting. On examination, all patients had abdominal tenderness, while rebound tenderness in the right iliac fossa (RIF) was found in 92.8% (52/56) of the patients. Laboratory investigations showed elevated leukocyte count in 76.7% (43/56) of patients. Appendicitis was diagnosed on ultrasound in 57.4% (31/54) of the patients, and free fluid was visualized in 40.7% (22/54) of the patients. Appendicitis was diagnosed on CT scan in all 25 patients, and free fluid was visualized in 64% (16/25) of the patients. The number of admission days ranged from 1 to 5 days, with a median of 2 days. And 62.5% (35/56) of patients were discharged in the first 2 days from admission. Major and minor complications after surgery were documented in 4 and 14 patients, respectively. Pathology reports showed features of acute appendicitis in all the resected appendices. <b><i>Conclusions:</i></b> Acute appendicitis in children should be suspected in all children with acute abdominal pain. This study can help guide the management of pediatric appendicitis and allow proper and standardized documentation of findings and judicious use of laboratory and radiological investigations.