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Intraluminal appendiceal fluid is a predictive factor for recurrent appendicitis after initial successful non-operative management of uncomplicated appendicitis in pediatric patients
Authors:Yuhki Koike  Keiichi Uchida  Kohei Matsushita  Kohei Otake  Makoto Nakazawa  Mikihiro Inoue  Masato Kusunoki  Yoshihide Tsukamoto
Affiliation:1. Department of Pediatric Surgery, National Mie Hospital, Mie, Japan;2. Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan
Abstract:

Background

The risk factors for recurrent appendicitis in pediatric patients are unclear. This study aimed to identify the predictive factors for recurrent appendicitis in pediatric patients who initially underwent successful non-operative management of uncomplicated appendicitis.

Methods

Potential predictive factors for recurrent appendicitis in terms of clinical characteristics, laboratory data, and abdominal ultrasonography and computed tomography findings, were evaluated.

Results

This study included 125 patients who underwent initial successful non-operative management of appendicitis. The rate of recurrent appendicitis was 19.2%, and the mean time to recurrence was 12.6 months. Univariate analyses found that rebound tenderness, muscle guarding, appendicoliths, appendiceal diameter > 9 mm, and intraluminal appendiceal fluid were associated with recurrent appendicitis.Multivariate analysis identified only intraluminal appendiceal fluid as an independent predictor of recurrent appendicitis.

Conclusions

Intraluminal appendiceal fluid is a predictive factor for recurrent appendicitis after initial non-operative management. The results of this study provide valuable information that may help to determine the appropriate management during the first episode of appendicitis.
Keywords:Recurrent appendicitis   Pediatric   Predictive factor   Intraluminal appendiceal fluid
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