Analysis of Cases of Neonatal Appendicitis from a Tertiary Care Unit.

OBJECTIVE: To compare the clinical characteristics and prognosis of neonatal appendicitis (NA) alone and neonatal appendicitis with neonatal necrotizing enterocolitis (NEC) to improve the early recognition and diagnosis rate for this type of disease. METHODS: Cases of appendicitis proved by operation and pathology younger than 28 d old in the authors hospital from 1990 to 2021 were retrospectively analyzed. According to whether combine with NEC, the cases were divided into two groups, analyzes the clinical characteristics. RESULTS: A total of 48 patients were enrolled, 15 cases in the NA group and 33 cases in the NEC with NA group. The age of onset, time from onset of symptoms to surgical intervention were both earlier in the NEC with NA group (p < 0.05). The preoperative white blood cells (WBC) and platelets (PLT) in the NA group were higher (p < 0.05). NEC with NA was more likely to be complicated with neonatal pneumonia and sepsis before surgery (p < 0.05). The main clinical symptom of NA was abdominal distension, while the other was bloody stool. The positive rate of ultrasound was high before the operation. The perforation rate of the appendix was very high (NA 100% vs. NEC 57.6%). In the NA group, 100% underwent appendectomy and 78.8% in the NEC with NA group underwent terminal ileostomy and appendectomy. CONCLUSION: The incidence of neonatal appendicitis is low. It is easily misdiagnosed as NEC. The perforation rate is very high, it is recommended to operate as soon as possible, and the prognosis is good.

Complications after transabdominal soave's procedure in children with hirschsprung's disease / Complicações após o procedimento de soave transabdominal em crianças com doença de hirschsprung

ABSTRACT Background: Hirschsprung's disease is a congenital disorder that causes functional obstruction of large bowel. Aim: To evaluate complication and bowel function score of children with Hirschsprung's disease who underwent transabdominal Soave's procedure. Methods: In this study all the children with Hirschsprung's disease who underwent transabdominal Soave procedure were evaluated regarding bowel function and complication of trans-abdominal Soave's procedure. Results: Were enrolled 160 children. Enterocolitis and constipation were seen in 15% of the cases. Fecal incontinency was the least frequent study which was seen in 1% of the children. Conclusion: Constipation and enterocolitis was the most frequent complication following transabdominal Soave technique.

RESUMO Racional: A doença de Hirschsprung é um distúrbio congênito que causa obstrução funcional do intestino grosso. Objetivo: Avaliar as complicações e o escore de função intestinal de crianças com a doença submetidas ao procedimento transabdominal de Soave. Métodos: Neste estudo, todas as crianças com doença de Hirschsprung submetidas ao procedimento transabdominal de Soave foram avaliadas quanto à função intestinal e complicação do procedimento. Resultados: Foram incluídas 160 crianças. Enterocolite e constipação foram observadas em 15% dos casos. A incontinência fecal foi menos frequente e observada em 1% das crianças. Conclusão: Obstipação e enterocolite foram as complicações mais frequentes após a técnica de Soave transabdominal em crianças.