Experience of Treating Acute Appendicitis in Tashkent
Аннотация
Modern diagnostics of acute appendicitis in children should include abdominal ultrasound investigation upon admission to a specialized hospital, if necessary, in an ultrasound monitoring mode during clinical dynamic observation of the child. Surgical treatment is indicated only for destructive appendicitis. The method of a surgical treatment choice is laparoscopic surgery including destructive appendicitis complicated by appendicular peritonitis. Surgeries in acute appendicitis make up 75% of all emergency surgical interventions. Annually only in the Republican Research Centre of Emergency Medicine 700 appendectomies in children are made on average. The article summarizes data obtained in the retrospective analysis of case histories of 6 256 patients with acute appendicitis and its complications who were hospitalized in the pediatric department of emergency surgery for 12 years. The following incidence of acute appendicitis in children is reported: from 1 to 3 years old - 0.6 per 1 000; from 4 to 7-1.4 - 2.6 per 1 000; 13 years of age - 8 per 1 000. The authors discuss specific features in the clinical picture of acute appendicitis in children depending on patient’s age and anatomical location of the appendix. The clinical picture in children of older age and of the first three years of life is discussed separately. Among 6 256 pediatric patients with acute appendicitis 72 (1.15%) were children younger than 3 years. The authors have substantiated a complex of diagnostic and therapeutic manipulations as well as tactic options to the treatment of this category of patients. Widespread implementation of the laparoscopic technique into surgical practice has significantly changed the tactics of treatment. The number of surgeries for simple appendicitis in children has decreased up to 3.9-7%.