小児虫垂炎における穿孔症例の臨床的検討

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  • A CLINICAL STUDY OF THE PERFORATED ACUTE APPENDICITIS IN CHILDREN

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Ninety-five children with acute appendicitis have been operated on at the department in a recent 15-year period. They were classified into non-perforated and perforated cases by operative findings and further subdivided into two grouups; younger than 5 years and from 6 to 15-year-old. There were 59 non-perforated cases and 36 perforated cases. Perforated cases younger than 5 years (58%) were more than perforated cases from 6 to 15 years (33%). The most common complaint was abdominal pain as a whole. But the appearance of nausea and/or vomiting became frequent in perforated cases, especially, that in youngers than 5 years was higher than that of abdominal pain. Muscle rigidity or defense musculare was a characteristic finding of perforated cases, but it was less useful diagnostic value in youngers under 5 years. The white blood cell counts were less in perforated cases younger than 5 years but more in perforated cases from 6 to 15-year-old. The body temperature was significantly higher in perforated cases. The frequency of perforated cases undergoing an operation within or after 48 hours was 23% or 63% respectively. It was suggested that the patients undergoing a delayerd operation prone to develop perforation. Of operated cases within 48 hours after the onset of the disease, perforation more frequently occurred in younger cases under 5 years (50%) than those between 6 and 15-year-old (17%), in dicating a rapid progress of the disease in younger children.

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