Chen Wei,Liu Lu,Liu Tingting,et al.Clinical features,diagnoses and treatments of acute appendicitis in immunocompromised children[J].Journal of Clinical Pediatric Surgery,2025,(02):159-164.[doi:10.3760/cma.j.cn101785-202112055-010]
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Clinical features,diagnoses and treatments of acute appendicitis in immunocompromised children

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: Number: 2025年02 Page: 159-164 Column: 论著 Date of publication: 2025-02-28
Author(s):
Chen Wei1; 2;  Liu Lu1;  Liu Tingting3;  Wang Dayong3;  Zhang Tingchong1;  Chen Yajun1
1. Department of General Surgery, Affiliated Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China;
2. Department of Pediatric Surgery, Beijing Tsinghua Changgung Hospital, Beijing 102218, China;
3. Department of Emergency Surgery, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China
Keywords:
Acute Appendicitis; Immunocompromised; Pathological Conditions;  Signs and Symptoms; Appendectomy; Conservative Treatment; Treatment Outcome; Child
DOI:
10.3760/cma.j.cn101785-202112055-010
Abstract:
Objective To explore the clinical characteristics and treatment of acute appendicitis in children with immune compromise. Methods From March 2007 to December 2020,the relevant clinical data were retrospectively reviewed for 29 immunocompromised children of acute appendicitis (AA) hospitalized at Affiliated Beijing Children’s Hospital.Demographic profiles,clinical manifestations,laboratory tests and imaging findings were recorded. Results There were 21 boys and 8 girls with a male-to-female ratio of 2.63∶1.Median age was 4.4(3.05,8.45) year.Major symptoms included fever (n=24,82.8%) and abdominal pain (n=24,82.8%).And major physical signs included abdominal tenderness (n=23,79.3%),muscular rigidity (n=9,31.0%) and rebound tenderness (n=8,27.6%).Sixteen cases (n=16,55.2%) were accompanied by neutropenia (moderate,n=1;severe,n=15).All of them recieved multiple antibiotics.And 18 children (n=18,62.1%) were treated with one or more special restricted antibiotics.Ten children (n=10,34.5%) were operated upon an initial diagnosis of AA.Laparoscopy (n=7) and open surgery (n=3) were performed.Two laparotomic cases developed postoperative incision infection.And one laparoscopic case of intestinal obstruction at Month 2 post-operation was relieved after conservative measures.Nineteen children were treated conservatively.Except for 1 case giving up treatment due to multiple organ failure,18 children were clinically cured and discharged.Nine children underwent elective appendectomy during follow-ups and there were no perioperative complications. Conclusions For immunocompromised AA children,timely empirical co-dosing of broad-spectrum antibiotics is efficacious.If there are no absolute surgical contraindications,early surgery is both safe and effective.

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Memo

收稿日期:2021-12-5。
通讯作者:陈亚军,Email:chenyajunmd@aliyun.com

Last Update: 2025-02-28