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Appendectomy in childhood: Analysis of 105 negative explorations
Authors:Martin J. Bell  Richard J. Bower  Jessie L. Ternberg
Affiliation:St. Louis, Missouri, USA
Abstract:Laparotomy with a preoperative diagnosis of acute appendicitis disclosed a normal appendix in 105 children (22.1 percent). In less than half of these, another condition was found or later identified, which explained the symptoms leading to operation. Ovarian lesions, acute ileocolitis, and serositis were the most frequently identified abnormalities. Twelve patients (11 percent) underwent definitive procedures in addition to appendectomy. Among patients in whom no abnormality was identified at laparotomy, peritoneal cultures yielded a broad range of organisms in 42 percent of those who had cultures. This may represent a mild form of acute primary peritonitis and may explain the symptoms which were confused with acute appendicitis.
Keywords:Requests for reprints should be addressed to Martin J. Bell   MD   Division of Pediatric Surgery   St. Louis Children's Hospital   500 South Kingshighway   St. Louis   Missouri 63110.
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