Our Summary

This study looks at how appendicitis in children is being treated in the United States. It uses data from a large national registry to examine various aspects of the patient’s experience, such as their characteristics, whether they had any imaging tests before surgery, the details of the operation, the results of any pathology tests, and any complications or deaths after surgery. The data included over 9,500 cases from 106 hospitals, and the patients were mainly boys aged 6 to 12. The study found that most children had imaging tests before surgery, and that a laparoscopic (minimally invasive) approach was used in most cases. The rates of unnecessary surgery and complications were both low, although younger children were more likely to have unnecessary surgery. Despite guidelines recommending against it, over a third of the children had a CT scan before surgery, especially if they were transferred from another hospital. The study concludes that the outcomes for children with appendicitis are generally very good, but there is room for improvement in terms of reducing unnecessary CT scans and surgery.

FAQs

  1. What age group and gender are most common in children undergoing appendectomy based on the study?
  2. What is the rate of unnecessary surgery and complications in appendectomy for children?
  3. According to the study, what is the common imaging test done on children before undergoing appendectomy and how can this process be improved?

Doctor’s Tip

One helpful tip a doctor might tell a patient about appendectomy is to follow the post-operative care instructions carefully, including taking prescribed medications, avoiding strenuous activities, and watching for signs of infection or complications. It is important to follow up with your doctor for any concerns or questions during the recovery process. Additionally, maintaining a healthy diet and staying hydrated can aid in a smooth recovery after surgery.

Suitable For

Patients who are typically recommended for an appendectomy include those who present with symptoms of appendicitis, such as abdominal pain, nausea, vomiting, and fever. Imaging tests, such as ultrasound or CT scan, may be performed to confirm the diagnosis. In most cases, surgery is recommended to remove the inflamed appendix and prevent complications such as a burst appendix. Children, in particular, are often recommended for appendectomy as they are at a higher risk for complications if appendicitis is left untreated. The study mentioned above focuses on children with appendicitis and highlights the importance of appropriate imaging tests and surgical approaches in their treatment.

Timeline

Before appendectomy:

  • Patient experiences symptoms such as abdominal pain, nausea, vomiting, and fever
  • Patient may visit a healthcare provider who will conduct a physical examination and may order imaging tests such as ultrasound or CT scan to confirm the diagnosis of appendicitis
  • Patient may be admitted to the hospital for observation and to receive intravenous antibiotics
  • Surgeon consults with patient and family to discuss the need for surgery and potential risks and benefits

After appendectomy:

  • Patient undergoes surgery to remove the inflamed appendix, either through open surgery or laparoscopic surgery
  • Patient recovers in the hospital for a few days, receiving pain medication and antibiotics
  • Patient is monitored for any complications such as infection or abscess formation
  • Patient is discharged from the hospital and instructed on post-operative care, including wound care and activity restrictions
  • Patient follows up with the surgeon for a post-operative visit to ensure proper healing and address any concerns

What to Ask Your Doctor

  1. What are the risks and benefits of having an appendectomy?
  2. What type of anesthesia will be used during the surgery?
  3. How long is the recovery time after an appendectomy?
  4. What are the potential complications or side effects of the surgery?
  5. Will I need to stay in the hospital after the surgery?
  6. Will I have any restrictions on activities or diet after the surgery?
  7. How soon can I expect to return to normal daily activities?
  8. What follow-up care will be needed after the surgery?
  9. Are there any alternative treatments to surgery for appendicitis?
  10. What can I do to prevent future episodes of appendicitis?

Reference

Authors: Childers CP, Dworsky JQ, Massoumi RL, Shenoy R, Maggard-Gibbons M, Lee SL, Russell MM. Journal: Surgery. 2019 May;165(5):1027-1034. doi: 10.1016/j.surg.2018.12.019. Epub 2019 Mar 21. PMID: 30905469