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- Title
APENDICITE AGUDA EM CRIANÇAS: INVESTIGAÇÃO CLINICA E TRATAMENTO CIRÚRGICO DE EMERGÊNCIA.
- Authors
Bastos Pires de Sousa, Ana Carolina; Cantanhede Viana, João Fernando; Oliveira, Beatriz Pereira; da Fonseca, Breno Belizario; Silva, Gelson da Costa; de Macêdo, Israel Santos; Moraes, Thulyo Monteiro; Primo, Giovana Bordi; Machado de Andrade, Vitor Soares; Soares, Vanessa Carvalho
- Abstract
Introduction: Acute appendicitis in children is a medical condition that requires urgent attention and precise intervention. Symptoms often include severe abdominal pain, initially around the navel and then migrating to the lower right side of the abdomen, in the region where the appendix is located. However, for a more accurate assessment of the condition and severity of the inflammation of the appendix, the use of imaging tests such as ultrasonography and computed tomography (CT) is often necessary. Ultrasonography, in particular, is preferred in children due to the absence of ionizing radiation. Emergency surgical treatment, known as appendectomy, is the standard approach to acute appendicitis. The procedure involves removing the inflamed appendix. Objective: To examine current clinical research practices and emergency surgical approaches for acute appendicitis in children and to assess the outcomes and complications associated with these practices. Methodology: following the PRISMA checklist to conduct the systematic review, using the PubMed, Scielo and Web of Science databases and five descriptors were used to select relevant studies: "Acute Appendicitis", "pediatrics", "Clinical Evaluation", "Emergency Surgery" and "Systematic Review". The inclusion criteria considered studies in English or Portuguese, focusing on acute appendicitis in children, clinical research, and emergency surgical treatment, involving pediatric patients. Exclusion criteria included unavailable studies, exclusively adult samples, and research unrelated to the topic. Results: 15 articles were selected for this study. Acute appendicitis in children usually presents with abdominal pain, usually starting around the navel and migrating to the right lower quadrant. Other common symptoms include anorexia, nausea, vomiting, and low-grade fever. Laboratory tests such as a complete blood count with differential may help evaluate leukocytosis and left shift, which are suggestive of appendicitis. Imaging studies, including ultrasonography and computed tomography (CT), play a crucial role in confirming the diagnosis, as ultrasonography is often the initial imaging modality of choice in pediatric patients. Treatment of acute appendicitis in children is based on emergency surgery, usually an appendectomy. Appendectomy may be done laparoscopically or by open approach, depending on the surgeon's experience and the patient's condition. Antibiotic preoperative prophylaxis is recommended to reduce the risk of surgical site infections. Commonly used antibiotics include cefoxytin, cefotetane, or cefazolin plus metronidazole. Conclusion: Acute appendicitis in children requires immediate clinical evaluation and appropriate diagnostic investigations to confirm the diagnosis. Surgical intervention, in the form of an appendectomy, continues to be the basis of treatment. Preoperative antibiotic prophylaxis is recommended to reduce the risk of infections of the surgical site. It is essential to adapt the choice of antibiotics based on local resistance patterns and individual patient factors.
- Subjects
SURGICAL site infections; BLOOD cell count; PATIENTS' attitudes; SURGICAL emergencies; MEDICAL research
- Publication
Revista Foco (Interdisciplinary Studies Journal), 2023, Vol 16, Issue 10, p1
- ISSN
1981-223X
- Publication type
Article
- DOI
10.54751/revistafoco.v16n10-188