Failure in the nonoperative management of pediatric ruptured appendicitis: predictors and consequences

摘要: Abstract Introduction The initial nonoperative management of perforated appendicitis fails in 15% to 25% children. These children have complications and increased hospitalization. purpose this study was identify predictors failure. Methods Children with treated antibiotics intent for over a 4-year period were reviewed. Seventy-five identified included the study. Failure defined as undergoing appendectomy before initially planned interval. Results Nine (12%) patients required sooner than planned. Age, presenting symptoms, physical examination findings, white blood cell (WBC) count similar both success failure groups. Absence abscess presence appendicolith multivariate analysis, which small bowel obstruction. failed group had longer median total length stay (18 days [range, 4-67] vs 8 4-31]; P = .002) underwent 3 times many computed tomography scans successes (3 2-7] 1 0-5]; Conclusion Lack an predict even when effect obstruction is accounted for. these characteristics may benefit from alternative strategies.