Acute neonatal appendicitis: A diagnosis to consider in abdominal sepsis

Arias-Llorente, R.P.; Flórez-Díez, P.; Oviedo-Gutiérrez, M.; Suárez-Rodríguez, M.; Costa-Romero, M.; Solı́s, Gonzalo; García-López, E.

doi:10.3233/npm-14814003

Cited by 13 publications

(16 citation statements)

References 19 publications

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“…Считается, что в результате перинатальной гипоксии, инфицирования плода, морфологической и функциональной незрелости на фоне течения тяжелой формы грамотрицательного дисбактериоза может развиться геморрагический или септический инфаркт стенки червеобразного отростка, а более редкими причинами возникновения аппендицита могут быть инородные тела, сдавления тяжами брюшины при незавершенном повороте кишечника. Однако существует мнение, что острый аппендицит является нетипичной формой язвенно-некротического энтероколита периода новорожденности [3,6,7]. В неонатальном периоде актуальным сохраняется трудность дифференциальной диагностики аппендицита с некротическим энтероколитом (НЭК), которые имеют одинаковый спектр факторов риска и схожую клиническую картину [2,5,7,8] Сонография ОБП от 20.03.2018 09:00: cвободной жидкости в брюшной полости нет; в правой подвздошной области определяется конгломерат из петель кишечника размером 29,4 × 16,4 мм, с отсутствием перистальтики и содержимого в просвете, с анэхогенным образованием внутри размером 5,9 × 2,3 мм.…”

Section: Discussionunclassified

“…Однако существует мнение, что острый аппендицит является нетипичной формой язвенно-некротического энтероколита периода новорожденности [3,6,7]. В неонатальном периоде актуальным сохраняется трудность дифференциальной диагностики аппендицита с некротическим энтероколитом (НЭК), которые имеют одинаковый спектр факторов риска и схожую клиническую картину [2,5,7,8] Сонография ОБП от 20.03.2018 09:00: cвободной жидкости в брюшной полости нет; в правой подвздошной области определяется конгломерат из петель кишечника размером 29,4 × 16,4 мм, с отсутствием перистальтики и содержимого в просвете, с анэхогенным образованием внутри размером 5,9 × 2,3 мм. В анализах крови подтверждены признаки воспалительной реакции: число лейкоцитов сохранялось высоким -15,9 × 10 9 , уровень CРБ -44 мг/л.…”

Section: Discussionunclassified

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Clinical cases: acute appendicitis in newbons

Bocharov¹,

Владиславович²,

Pogorelko³

et al. 2021

Russian Journal of Pediatric Surgery, Anesthesia and Intensive

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Aim. The goal of this study is to describe the clinical observations of acute appendicitis in two newborn infants. This study was a retrospective analysis performed using data obtained from medical records. Two preterm infants had a gestational age of 33 weeks, a threat of pregnancy termination, rapid childbirth in one case, and a cesarean section in another. At birth, their body weights were low, 2340 and 2420 g, respectively. The condition of the babies was evaluated on the Apgar scale, and both scored 7/8 points. We studied the data of clinical, laboratory, and instrumental study data and surgical intervention protocols. In the presented newborns, neonatal jaundice, respiratory failure of the III degree, and hypoxic perinatal damage to the central nervous system occurred from birth. On the first childs twelfth day and the second childs ninth day, they experienced a clinically acute inflammatory process in the abdominal cavity, confirmed by inflammation markers (high white blood cell counts and levels of C-reactive protein). According to the sonography of the abdominal organs, the absence of intestinal motility in the right abdominal cavity, the presence of intestinal wall pneumatosis, signs of conglomerate formation from the intestinal loops were revealed. The surgical interventions performed were a laparoscopy and a conversion to laparotomy. In both cases, inflammatory bowel changes corresponded to the course of necrotic enterocolitis, diagnosed with gangrenous-perforated appendicitis and purulent-fibrinous peritonitis. In the section, the mucous appendix was not changed. Conclusion. The aggravated premorbid background in premature infants predisposes them to necrotic enterocolitis, which can occur in children of this age with isolated perforation of the appendix. The course of necrotic enterocolitis is complicated by the formation of purulent-fibrinous peritonitis due to the destruction of the appendix with minimal changes in its walls.

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Section: Discussionunclassified

Clinical cases: acute appendicitis in newbons

Bocharov¹,

Владиславович²,

Pogorelko³

et al. 2021

Russian Journal of Pediatric Surgery, Anesthesia and Intensive

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“…The mortality rate of neonatal appendicitis has decreased to 18% from 28% due to the awareness of the disease and earlier diagnosis. 9 However, the mortality rate may exceed 50% in the case of delayed diagnosis and in the presence of possible complications such as diffuse peritonitis. 10 The treatment of appendicular perforation primarily is surgery.…”

Section: Discussionmentioning

confidence: 99%

Appendicular perforation in a neonate: a case report

Badhani¹,

Singh²

2019

Int Surg J

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Appendicitis and the consequent appendicular perforation are mostly rare in neonates. It is more common in premature babies though. Presentation therefore may mimic necrotizing enterocolitis although this is usually not so severe. We report a case of appendicular perforation in a term neonate who presented as peritonitis. Diagnosis was made after the exploration. Patient did well after surgery. Although rare, appendicular pathology should be entertained in any case of peritonitis even though the presentation is not the same as in older children due to various anatomical reasons. Primary treatment is surgery.

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“…[3][4][5][6][7][8][9][10][11] The Clinical features of NA are very atypical, which leads to misdiagnosis and delayed treatment. [4,6] In addition, perforation of NA is more common, that results in high morbidity and mortality. [2,[6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

An Experience with 31 Cases of Neonatal Appendicitis: A Retrospective Study

Huang

Mbugi

et al. 2019

J Neonatal Surg

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Background: Neonatal appendicitis (NA) is rarely diagnosed due to lack of specific symptoms and signs. The aim of this study is to share our experience with NA.Methods: We performed a retrospective data review from electronic medical records of patients admitted at Children’s Hospital of Chongqing Medical University (CHCMU) with the clinical diagnosis of NA from October 2001 to July 2018.Results: Of 31 neonates, male neonates (n=20) accounted for 64.5%. Abdominal distension and anorexia were the most common clinical features (61.3%, n=19). Neonates with elevated C- reactive protein (CRP) accounted for 92.6% (n=25) where as 51.6% (n=16) had normal white blood cell count (WBC). Of 29 neonates who underwent surgery, 69% (n=20) had perforated appendicitis.Conclusion: Neonatal appendicitis lacks specific clinical features, and early diagnosis is difficult. Clinicians need to have high index of suspicion when attending neonates with features of abdominal sepsis.

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Acute neonatal appendicitis: A diagnosis to consider in abdominal sepsis

Cited by 13 publications

References 19 publications

Clinical cases: acute appendicitis in newbons

Clinical cases: acute appendicitis in newbons

Appendicular perforation in a neonate: a case report

An Experience with 31 Cases of Neonatal Appendicitis: A Retrospective Study

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