Study for a Rational Management of Appendicitis in Children
Study for a Rational Management of Appendicitis in Children
Despite the fact that appendicitis is one of the most frequent surgical pathology in
 children, its clinical management is still debated. Previous reports have shown rate of
 appendectomy in children without appendicitis up to 30 %. Morbidity, due to infectious
 complications or intestinal obstruction, is often between 5 and 10 % of published cases, and
 increase medical and social costs. Evidence-based medicine concept could therefore be
 worthwhile in that context, in order to promote rational diagnosis and treatment of that
 frequent medical condition.An algorithm describing management of children with suspicion of
 appendicitis was established, based on recent published data, in order to reduce delay
 between first clinical signs and confirmation of the diagnosis, and to define therapeutic
 indication such as conservative management and interval appendectomy or patient requiring
 laparoscopic approach. The main objective of the study is to decrease morbidity and
 unnecessary appendectomy rates, and secondly to decrease costs, by the use of that algorithm.
Inclusion Criteria:

 -  male and female children, between 4 and 15 years-old, with more than 37,5°C of body
 temperature during the 3 days before hospital admission, and with abdominal pain
 located in right or median lower quadrant

 Exclusion Criteria:

 -  children coming from another hospital, children with septic choc, children with
 co-morbidity in interaction with algorithm (antibiotics allergy, mellitus diabetes,
 haemostasis disturbance, …)