Background and Objectives: Acute appendicitis in pediatric patients is one of the most common surgical emergencies, but the early diagnosis still remains challenging. The aim of this study was to determine the predictive value of Red blood cell distribution width (RDW), Mean platelet volume (MPV) and Platelet distribution width (PDW) in children with acute appendicitis. Materials and Methods: This study was a retrospective assessment of laboratory findings (RDW, MPV, PDW) of patients who underwent surgical treatment for acute appendicitis from January 2019 to December 2020. Result: During this period, 223 appendectomies were performed at our Institute. In 107 (43%) cases appendicitis was uncomplicated, while in 116 (46.6%) it was complicated. WBC and RDW/MPV ratio were significant parameters for the diagnosis of acute appendicitis with cut-off values of 12.86 (susceptibility: 66.3%; specificity: 73.2%) and 1.64 (susceptibility: 59.8%; specificity: 71.9%), respectively. WBC and RDW/RBC ratio were independent variables for the diagnosis of complicated appendicitis. The cut-off values were 15.05 for WBC (sensitivity: 60.5%; specificity: 70.7%) and 2.5 for RDW/RBC ratio (sensitivity: 72%; specificity: 52.8%). Conclusions: WBC is an important predictor of appendicitis and complicated appendicitis. RDW, MPV and PDW alone have no diagnostic value in pediatric acute appendicitis or predicting the degree of appendix inflammation. However, the RDW/MPV ratio can be an important predictor of appendix inflammation, with higher values in patients with more severe appendix inflammation. RDW/RBC ratio may be an important predictor of complicated appendicitis.

Since there are no pathognomonic symptoms, clinical or laboratory findings, diagnosis of this condition is challenging. Familiarity with Doppler whirlpool sign can enable a timely diagnosis and treatment of isolated fallopian tube torsions. However, the diagnosis is rarely made before operation. Unlike in our case, surgery is often performed too late, and delay of intervention may result in failure to save the fallopian tube.

The house in Gajeva Street is now used as the municipality office. However, this house with its story recommends itself to become a house for a special social function, such as a museum of medical history of Novi Sad. A small investment could make it possible to collect, preserve and display the valuable records of our past, which is something we do owe to the generations to come.

Introduction/Objective. Studies about possibilities of conservative, i.e. non-operative management of acute uncomplicated appendicitis in adult and pediatric population have been published lately, considering benefits of preserving appendix and potential complications related to appendectomy. Methods. In this retrospective study medical data of 76 patients treated at the Institute for Child and Youth Health Care of Vojvodina in Novi Sad for acute uncomplicated appendicitis in 2015 and 2016 have been analysed, comparing length of stay, antibiotic therapy use, complications occurement, as well as the financial burden depending of the type of therapy applied. Results. During this period, 76 patients (55 operated and 21 treated conservatively) were treated for acute uncomplicated appendicitis. Conservatively treated children spent statistically significantly shorter period of time at the hospital compared to the operated ones (4.24 vs. 5.76 days; p < 0.001). Early surgical complications occurred in 10.91% operated and 9.52% non-operated children, which wasn?t statistically significant difference (p = 0.863). The total cost of hospital stay was significantly lower in those who underwent non-operative management (10,340 RSD vs. 54,281 RSD; p = 0). The difference was significant even when analyzing costs related to rehospitalization and operative treatment of children initially treated conservatively (p < 0.001). Conclusion. Non-operative i.e. conservative treatment of acute uncomplicated appendicitis in the pediatric population is safe and effective compared to the operative one, and it is not associated with more frequent occurrence of early surgical complications. Total costs for the non-operative treatment are significantly lower, even considering costs related to re-hospitalization of children initially treated conservatively.