[Abstract] Objective To analyze the clinical characteristics of neonatal appendicitis, and to discuss the diagnosis and treatment of neonatal appendicitis. Methods
Twenty-one patients with neonatal appendicitis admitted from August 2009 to June 2014 were retrospectively analyzed. Among them, male
16 cases, 5 cases, age 1 day~28 days, mean age 11 days. The detailed clinical indicators of the 21 neonatal patients were statistically analyzed. Results
All 21 cases were treated surgically, among which 9 cases were diagnosed with neonatal appendicitis before surgery, 7 cases were diagnosed with gastrointestinal perforation, 5 cases were investigated by dissection due to severe peritonitis, intraoperative appendicitis was confirmed, appendectomy was performed in all cases, and 2 cases were abandoned; 2 cases developed incisional infection and recovered well after drug exchange, 7 cases were neonatal necrotizing small intestinal colitis combined with appendicitis, intestinal fistula was performed in one stage, and intestinal closure was performed 3 months later. In 7 cases, necrotizing small bowel colitis combined with appendicitis was treated with intestinal fistula in the first stage and intestinal fistula was performed 3 months later; in 2 cases, congenital megacolon was combined with megacolon, and then megacolon radical surgery was performed. The prognosis was good except for two cases that were abandoned. The main clinical symptoms were vomiting, abdominal distension, fever, refusal of milk, redness of the abdominal wall, and abdominal mass. The bacterial culture results showed that the causative organisms were mainly Klebsiella pneumoniae, Escherichia coli and Enterococcus faecalis. The pathological results were acute gangrenous appendicitis in 14 cases and purulent appendicitis in 7 cases. Conclusion
Appendicitis in neonates is very rare, the clinical manifestations are very atypical, and it is difficult to make a clear diagnosis at an early stage, and most of the preoperative diagnoses are gastrointestinal perforation, peritonitis, intestinal obstruction, etc. Abdominal ultrasonography is helpful for the diagnosis of appendicitis in neonates, and early diagnosis, active surgery, reasonable application of antibacterial drugs and nutritional support therapy can effectively reduce mortality. Wang Hefeng, Department of Pediatric Surgery, Jinan Children’s Hospital [Keywords] Neonatal appendicitis; peritonitis; diagnosis; treatment