EP 451 ER to OR: Paediatric Appendicectomy Practice in a District Hospital
Neha Hande, Santhosh LoganathanAbstract
Introduction
Suspected appendicitis is a leading cause of emergency hospital admission in the UK paediatric population, with approximately 10,000 children undergoing appendicectomy each year. To evaluate local practice, we conducted an audit of paediatric patients who underwent appendicectomy at our hospital over a two-year period.
Methods
This retrospective audit included paediatric patients (<16 years) undergoing emergency appendicectomy at our hospital from June 2022 to June 2024.
Results
A total of 58 paediatric patients undergoing appendicectomy were audited, with 65.5% male and 34.5% female. Laboratory findings showed elevated WBC counts (>10,000) and neutrophilia in 82.75% of cases, while CRP <50 was observed in 53.44%. A Paediatric Appendicitis Score (PAS) >7 was recorded in 94.82% of patients. Ultrasound was performed in 14 patients, with 10 demonstrating features of acute appendicitis. Daytime surgeries accounted for 55.17% of cases. Intra-operative findings included inflamed appendix (70.6%), perforated appendix (17.27%), and gangrenous appendix (12.06%). Importantly, the negative appendicectomy rate was zero, confirmed by histology, with one patient diagnosed with a neuroendocrine tumour (NET).
Conclusion
Our findings underscore the reliability of our hospital’s diagnostic and surgical protocols for paediatric appendicitis, while highlighting the potential to optimize imaging use. Compared to the UK average negative appendicectomy rate of 10% reported by GIRFT, our audit’s zero rate emphasizes the accuracy of our diagnostic criteria and the effectiveness of our surgical decision-making.