Acute Appendicitis In Children At Teaching Paediatric Hospital Charles De Gaulle Of Ouagadougou BURKINA FASO: A Study With 367 Cases

摘要

Background: The purpose of this retrospective study is to determine the epidemiologic, clinic, therapeutic and evolutive aspects of acute appendicitis in children.Patients and Methods: We conducted a retrospective study over six years between January 1st 2005 and December 31st 2010 at the Training Paediatric Hospital Charles de Gaulle of Ouagadougou on 367 children from 0 to14 years old admitted for acute appendicitis and who benefited appendicectomy. The data have been constituted from emergency admission register, surgery protocols, hospitalized patient register, consultations register.Results: A total of 367 children were involved in the study. Acute appendicitis of children was frequent and represented 27% of non traumatic abdominal pain and 10.8% of digestive surgical interventions. Ages between 11 and 14 years old were most frequently seen (55.3%). The male-to-female ratio was 2.2. Eighty three (83.9%) of patients got treatment before their admission at surgical emergency departments. The mean consultation delay was 5.06 days. The rate of appendicular peritonitis (41%) has been too high. The mean delay of surgery in our study has been 20.4 hours. The appendix was perforated in 36.8% cases. Complications of surgery have been noticed in 12% of cases and parietal suppuration represented 90% of theses. The lethality linked to acute appendicitis has been 1.36%.Conclusion: The clinical figures of children acute appendicitis are superposable to adult one’s. The reduction of complications and lethality linked to acute appendicitis was in realtion to the reduction of consultation delay. INTRODUCTION Acute appendicitis in children can be defined as an inflammation of the vermiform appendix of the child. It is a frequent surgery emergency which stands as a major disorder in digestive surgery in paediatrics. Although its treatment is well standardized, diagnosing it in children is still a big challenge for practitioners.Bobossi and al. in Central African Republic have found that appendicitis which represents 32. 4% of all abdominal pain in children is the most common affection in children [1].Appendicitis has always been considered a trivial disease by the population, but in reality, it conveys dreadful complications and its socio- economic impact is very significant. The purpose of this study is to investigate the epidemiological, clinical, therapeutic and evolutionary aspects of acute appendicitis among in children. PATIENTS AND METHODS We have conducted a retrospective study from January 1st 2005 to December 31st 2010 in the surgery department of the Charles de Gaulle Paediatric Hospital on three hundred and sixty-seven (367) children aged 0-14 who have been admitted for acute appendicitis and who have undergone an appendicectomy. The data have been collected from the emergency admission register books, surgery report books, clinical files of hospitalized patients, their consultation and follow up charts. For each patient the following data have been sought:Sociodemographic characteristics: Patients’ age and gender, patients have been divided into three brackets: 0-5, 6-10, 11-14Hospitalization parameters: consultation time-limit, hospitalization periodClinical variable: functional symptomatology, general signs, pains characteristics, physical tests dataPara clinical variables: abdominal roentgenogram, abdominal scan, white numeration, the bacteriology of the peritoneal fluid, anatomical-pathological examTerms for better management (route first; observations during operation, actions done)Outcomes of the treatment RESULTS The surgery department registered during the period of study 5581 hospitalizations among which 1362 for non traumatic etiology of abdominal pain. Acute appendicitis represented 27%. Three thousand three hundred and eighty-nine (3389) patients got digestive surgical interventions among which 10.8 % for acute appendicitis. The average age of the entirety of our series was 10, 68 years ± 2, 65 years (extreme: 3- 14