Clinical recovery in children with uncomplicated appendicitis undergoing non-operative treatment: secondary analysis of a prospective cohort study

被引:0
作者
Max Knaapen
Johanna H. van der Lee
Hugo A. Heij
Ernst L. W. van Heurn
Roel Bakx
Ramon R. Gorter
机构
[1] University of Amsterdam,Pediatric Surgical Center of Amsterdam, Emma Children’s Hospital and VU University Medical Center, Amsterdam UMC
[2] University of Amsterdam,Pediatric Clinical Research Office, Academic Medical Center, Emma Children’s Hospital and VU University Medical Center, Amsterdam UMC
来源
European Journal of Pediatrics | 2019年 / 178卷
关键词
Pediatric surgery; Non-operative treatment; Uncomplicated appendicitis; Clinical recovery;
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摘要
Non-operative treatment of uncomplicated appendicitis in children is gaining ground. Pending definitive evidence regarding its effectiveness, there is a call to evaluate clinical recovery after non-operative treatment. In this study, we analyzed data collected during initial admission of a multicenter prospective cohort in which children, 7–17 year, were treated non-operatively for uncomplicated appendicitis. During admission clinical parameters (pain and gastro-intestinal symptoms), inflammation parameters and sequential abdominal ultrasound were recorded. In total, 45 children were included, 42(93%) were discharged without the need for appendectomy; median [IQR] pain scores on admission were 5 [4–7], decreasing to 2 [0–3] after 1 day of treatment. Initially, 28/42 (67%) reported nausea and 19/42 (45%) vomiting; after 1 day, this was 3/42 (7%) and 1/42 (2%), respectively. White blood cell count declined from a median [IQR] of 12.9 [10.7–16.7] 10E9/L on admission to 7.0 [5.8–9.9] 10E9/L on day 1. Median [IQR] C-reactive protein levels increased from 27.5 [9–69] mg/L on admission to 48 [22–80] mg/L on day 1, declining to 21.5 [11–42] mg/L on day 2. Follow-up ultrasound showed no signs of complicated appendicitis in any of the patients.
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页码:235 / 242
页数:7
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