Ciftci A O, Tanyel F C, Büyükpamukçu N, Hiçsönmez A
Department of Pediatric Surgery, Hacettepe University Medical Faculty, Ankara, Turkey.
Eur J Pediatr Surg. 1996 Dec;6(6):350-3. doi: 10.1055/s-2008-1071013.
The association of appendicitis and blunt abdominal trauma (BAT) is an exceptionally rare occurrence with a few case reports in the literature. The main question whether this association is a result of causative or coincidental relationship has not been evaluated among children. A retrospective clinical study was performed to clarify the pathogenesis, incidence, clinical characteristics and outcome of appendicitis diagnosed in children during the hospitalization period following blunt abdominal trauma (BAT). The records of 554 patients with BAT who were admitted to our unit between 1979 and 1993 inclusive were reviewed. Five patients (0.90%), 3 males and 2 females, with a mean age of 9.4 +/- 1.4 were found to have appendicitis. None of these patients had any signs or symptoms related to appendicitis prior to BAT. Bruising and rupture of the mesoappendix were noted in 3 patients while edema and hematoma of appendix and terminal ileum were found in two. Full recovery was achieved in all patients following appendicectomy. Our incidence of 0.90% is statistically significantly higher than the highest incidence rate of appendicitis stated in the literature during childhood (t-test for population proportion, t = 2.892; p < 0.05). We emphasise the possibility of a causative relationship between appendicitis and BAT depending on the clinical characteristics, operative findings, statistically significant high incidence rate and literature review.
阑尾炎与钝性腹部创伤（BAT）的关联极为罕见，文献中仅有少数病例报告。在儿童群体中，这种关联是因果关系还是偶然关系这一主要问题尚未得到评估。我们开展了一项回顾性临床研究，以阐明在钝性腹部创伤（BAT）后的住院期间被诊断出阑尾炎的儿童的发病机制、发病率、临床特征及预后情况。我们回顾了1979年至1993年（含）期间收治于我院的554例BAT患者的病历记录。发现5例（0.90%）患者患有阑尾炎，其中3例男性，2例女性，平均年龄为9.4±1.4岁。这些患者在发生BAT之前均无任何与阑尾炎相关的体征或症状。3例患者可见阑尾系膜瘀斑和破裂，2例患者发现阑尾及回肠末端水肿和血肿。所有患者在阑尾切除术后均完全康复。我们0.90%的发病率在统计学上显著高于文献中所提及的儿童期阑尾炎最高发病率（总体比例的t检验，t = 2.892；p < 0.05）。基于临床特征、手术所见、统计学上显著的高发病率以及文献综述，我们强调阑尾炎与BAT之间存在因果关系的可能性。
