valuation of the anatomic positions and situations of the appendix in pediatric patients with acute appendicitis

Abstract

OBJECTIVE: to access the different anatomic positions and situations of the appendix in pediatric patients diagnosed with acute appendicitis. METHOD: It´s an observational, cross-sectional study performed between august 2015 and July of 2016, at the Pediatric Emergency of the Restauration Hospital, in Recife, Brazil. The sample was composed of 56 patients from 7 to 13 years-old diagnosed with acute appendicitis. The clinic-epidemiologic data of the participants were collected before the surgical procedure. During the surgery, all anatomic characteristics of the appendices were gathered. (position, situation, length, period of the appendicitis). RFESULTS: The positions were: pelvic (37.5%), retrocecal (28.6%), pre-ileal (10.7%), post-ileal (8.9%), subcecal (8.9%), and paracecal (5.4%). Regarding situation, the most common was the descending (46.4%), followed by the ascending (28.6%), internal (19.6%), and external (5.4%). The main clinical manifestations observed were: pain in the lower right quadrant, vomits, and nausa, not related to the position of the appendix. The inflammatory period was the most frequent in all positions, except in the subcecal, with 60% being perforated. However, there was no statistically significant association between the subcecal position and the period of the complicated appendicitis (p = 0.367). CONCLUSION: The pelvic position and the descending situation were the most frequent in the studied population. There was no statistically significant association between the position of the appendix and the period of the appendicitis, and neither with the clinical case.