Acute Appendicitis
0 In children presenting with abdominal pain, the pain is mostly due to gastroenteritis, urinary infection, parasitosis or constipation.
It is common between 0 6-12 years old.
0 It is the most common cause of acute abdomen in children older than two years of age.
0 Obstruction of the appendix lumen for any reason is the event that triggers the inflammation of this organ.
0 In children, appendix is long, lumen diameter is narrower, and wall thickness is thin. Therefore, it perforates more quickly in children.
0 Since the base of the appendix is wide in newborns, the probability of obstruction is less.
0 Fecalitis are parasites, foreign bodies, submucosal lymphoid hyperplasia, or carcinoid tumors.
0 In children, the cause is often lymphoid hyperplasia.
0 E. coli and anaerobes are the most common causative agents.
Clinic
• Diagnosis is made mainly by history and physical examination.
• Clinical findings in children differ according to age group.
• Distension in neonatals
• Abdominal pain in children under 5 years old
• Between the ages of 5-12 (the most common age range), anorexia is the most common finding.
• Vomiting occurs after pain.
• The pain is then localized to the right lower quadrant.
• Fever is below 38oC unless perforation develops.
• The diseases that are most confused in the differential diagnosis are gastroenteritis and constipation. Also, attention should be paid to urinary tract infection and mesenteric lymphadenitis.
Treatment
• It is an appendectomy.
Primary Peritonitis
0 It is peritoneal inflammation that does not originate from intra-abdominal organs.
0 Most primary peritonitis in the pediatric age group is associated with nephrotic syndrome or chronic liver processes with ascites/cirrhosis.
0 isolated factors may vary depending on the coexistence.
0 S. pneumoniae and group A streptococci are the most common agents in patients with nephrotic syndrome.
0 It is effective in gram (+) cocci and gram (-) cocci, especially E. coli, in those with underlying liver disease.
0 Clinically, there is acute abdominal pain, fever, nausea, vomiting and diarrhea.
