Perforated appendicitis in children

Abstract

A ten-year experience with 677 cases of appendicitis demonstrated an increasing incidence of perforation. In addition, bacteriological cultures showed that gangrenous appendicitis was similar to appendicitis with microscopic perforation. On the basis of four criteria, the differential diagnosis of perforated appendicitis could be made with almost 90 percent accuracy. For children with gangrenous and perforated appendicitis, the preoperative administration of intravenous antibiotics significantly decreased the incidence of intra-abdominal abscess, while elevation of the head of the bed confined all such abscesses to the pelvis. Likewise, the frequency of wound infections in this same group of patients was reduced by means of a delayed closure of the skin and subcutaneous portions of the laparotomy incision. © 1971.