ACUTE APPENDICITIS IN YOUNG-CHILDREN IN THE BELFAST URBAN AREA - 1985-1992

Eighty-one cases of acute appendicitis in children aged less than six years were identifled in the Belfast urban area between 1985 and 1992. Appendiceal perforation, found in 43%, was related to symptom duratio n but not to age at presentation. Prolongation of symptoms was related to parental delay in seeking medical advice (52% > 36 hours), delayed or inappropriate general practitioner referral to hospital (19%) and diagnostic delay following surgical consultation (12% > 12 hours). Dia gnostic delay in hospital was usually the result of nonspecificity of symptoms and signs and was therefore largely unavoidable. Delayed refe rral from general practice did not contribute unnecessarily to appendi ceal perforation, and given that an individual general practitioner wi ll see a case of preschool appendicitis once in 30 years, diagnostic a ccuracy was remarkably high.