대한대장항문학회

This study is a clinical analysis of 266 pediatric Patients with acute appendicitis who<br>were admitted to the Department of Surgery, Seoul Red Cross Hospital during the<br>period of 6 years from March 1985 to February 1991 with a review of the literature, and<br>we compared perforated group with nonperforated group.<br>The results were as follows.<br>1) Nonperforated group were 208 cases and perforated group were 58 cases. In the<br>incidence of age, acute appendicits occured predominantly high between 11 years and 15<br>years(67.7%) and perforation ratio was high(50%) before 5 years. Male to female ratio<br>was 1.3 : 1. 21 In the symptom duration, perforated appendicitis was frequently<br>developed as longer symptom duration. After 48 hours from symptom attack, perforation<br>ratio was above 50%.<br>3) Perforation occured frequently in high body temperature at admission. Perforation<br>ratio was above 50% more than 38%.<br>4) The relation between age, symptom duration and body temperature, more than 48<br>hours of symptom duration, above 387 body temperature and less than 10 years age<br>were corresponding the perforation of acute appendicitis. When the 3 factor<br>was<br>included, perforation ratio was 91.7%.<br>5) There was no difference in white blood cell count and perforation ratio.<br>6) The types of perforation were localized peritonitis(46.6% ), diffuse peritonitis(31.0%<br>) and periappendiceal abscess(22.4%)<br>7) Peritoneal fluid culture was done 43 cases of 58 perforated group, most common<br>organism was E. coli, and remainder were Pseudomonas, Proteus, Alcaligenes feacalis,<br>Streptococci and Bacteroides.<br>8) The complication rate was 6.3% in nonperforated group and 51.7% in perforated<br>group, and the most common complication was wound infection. There were 2 cases of<br>postoperative deaths in this series.<br>9) Mean duration of hospitalization were 6.8?.1 days in nonperforated group and 13.5<br>?.4 days in perforated group.<br>