APPENDICITIS DIAGNOSED FOLLOWING ACTIVE OBSERVATION DOES NOT INCREASEMORBIDITY IN CHILDREN

An audit was undertaken to assess the outcome of patients aged less th an 16 years who underwent appendicectomy after active observation. A c omparison was made of the incidence of perforation, complications, and hospital stay of patients who underwent emergency appendicectomy (gro up A) and those who were operated upon after active observation (group B). A total of 1,672 patients were admitted with acute abdominal pain . Emergency appendicectomy following the diagnosis of acute appendicit is on admission was performed in 744 patients (group A); an appendicec tomy was performed in 126 patients following active observation (group B). In group A, 140 patients (18.8%) were found to have macroscopic o r microscopic perforations; a normal appendix was removed in 75 (10.1% ) cases and 31 (4.2%) patients developed postoperative complications. In group B, perforations occurred in 19 (15.1%) patients, a normal app endix was encountered in 25 (19.8%), and postoperative complications o ccurred in 7 (5.5%), The overall normal appendicectomy rate was 11.5%, Mean duration of hospital stay was 3.5 days in group A and 4.7 days i n group B. The remaining patients who were actively observed and did n ot require surgery were discharged when their symptoms and signs had r esolved. This study illustrates that appendicectomy after a period of active observation in hospital for acute abdominal pain carries no inc rease in morbidity compared with urgent appendicectomy.