Resumo
Acute appendicitis is one of the most common surgical emergencies in childhood, requiring rapid assessment and intervention. The clinical and radiological characteristics of this condition may vary in children, presenting significant diagnostic challenges. Surgical management is essential to avoid serious complications, such as perforation and peritonitis. Considering the importance of an early and precise approach, the evaluation and surgical management of appendicitis in pediatrics have been the subject of studies and systematic reviews to optimize clinical practice. Objective: To analyze and synthesize recent studies on the evaluation and surgical management of appendicitis in children, aiming to identify the best diagnostic and therapeutic practices. Methodology: The review was carried out in accordance with PRISMA guidelines. The PubMed, Scielo and Web of Science databases were searched for articles published in the last 10 years. The descriptors used included "pediatric appendicitis", "diagnosis", "surgery", "management" and "evaluation". The inclusion criteria were original studies focusing on clinical evaluation, imaging diagnosis and surgical management in pediatric patients with acute appendicitis. Exclusion criteria were studies in languages other than English, Portuguese or Spanish, case reports and narrative reviews. Results: The results highlighted the importance of careful clinical evaluation, together with the use of imaging tests, such as ultrasound and computed tomography, in the diagnostic approach to appendicitis in children. In addition, several surgical strategies were discussed, including laparoscopy, and the role of pre- and postoperative antibiotic therapy. Factors such as age, clinical presentation and time elapsed since the onset of symptoms were considered when making surgical decisions. Conclusion: The systematic review highlights the importance of a multidisciplinary and individualized approach in the evaluation and surgical management of appendicitis in pediatrics. The evidence gathered provides support to improve clinical practices, aiming for an effective and safe approach in this specific context.
Referências
Jumah S, Wester T. Non-operative management of acute appendicitis in children. Pediatr Surg Int. 2022 Nov 28;39(1):11. doi: 10.1007/s00383-022-05284-y.
Gil LA, Deans KJ, Minneci PC. Appendicitis in Children. Adv Pediatr. 2023 Aug;70(1):105-122. doi: 10.1016/j.yapd.2023.03.003.
Glass CC, Rangel SJ. Overview and diagnosis of acute appendicitis in children. Semin Pediatr Surg. 2016 Aug;25(4):198-203. doi: 10.1053/j.sempedsurg.2016.05.001
Bašković M, Zaninović L, Čizmić A, Žganjer M. Stump appendicitis in children: a systematic review. Pediatr Surg Int. 2023 May 15;39(1):199. doi: 10.1007/s00383-023-05475-1
He K, Rangel SJ. Advances in the Diagnosis and Management of Appendicitis in Children. Adv Surg. 2021 Sep;55:9-33. doi: 10.1016/j.yasu.2021.05.002.
López JJ, Deans KJ, Minneci PC. Nonoperative management of appendicitis in children. Curr Opin Pediatr. 2017 Jun;29(3):358-362. doi: 10.1097/MOP.0000000000000487
Wekell P, Wester T. Familial Mediterranean fever may mimic acute appendicitis in children. Pediatr Surg Int. 2022 Aug;38(8):1099-1104. doi: 10.1007/s00383-022-05153-8. Epub 2022 Jun 23.
Hall NJ, Eaton S. Non-operative management of appendicitis in children. Arch Dis Child. 2018 May;103(5):498-502. doi: 10.1136/archdischild-2017-313267.
Podda M, Gerardi C, Cillara N, Fearnhead N, Gomes CA, Birindelli A, Mulliri A, Davies RJ, Di Saverio S. Antibiotic Treatment and Appendectomy for Uncomplicated Acute Appendicitis in Adults and Children: A Systematic Review and Meta-analysis. Ann Surg. 2019 Dec;270(6):1028-1040. doi: 10.1097/SLA.0000000000003225.
Rentea RM, St Peter SD. Contemporary Management of Appendicitis in Children. Adv Pediatr. 2017 Aug;64(1):225-251. doi: 10.1016/j.yapd.2017.03.008.
Ayyıldız HN, Mirapoglu S, Akış Yıldız Z, Şahin C, Güvenç FT, Arpacık M, Ilce Z. What has changed in children's appendicitis during the COVID-19 pandemic? Ulus Travma Acil Cerrahi Derg. 2022 Dec;28(12):1674-1681. doi: 10.14744/tjtes.2021.51000.
Rassi R, Muse F, Cuestas E. Acute appendicitis in children under 4 years of age: A diagnostic dilemma. [Acute appendicitis in children under 4 years: a diagnostic dilemma]. Rev Fac Cien Med Univ Nac Cordoba. 2019 Aug 29;76(3):180-184. Spanish. doi: 10.31053/1853.0605.v76.n3.23661.
Xu J, Adams S, Liu YC, Karpelowsky J. Nonoperative management in children with early acute appendicitis: A systematic review. J Pediatr Surg. 2017 Sep;52(9):1409-1415. doi: 10.1016/j.jpedsurg.2017.05.003.
Almaramhy HH. Acute appendicitis in young children less than 5 years: review article. Ital J Pediatr. 2017 Jan 26;43(1):15. doi: 10.1186/s13052-017-0335-2.
Köhler F, Müller S, Hendricks A, Kastner C, Reese L, Boerner K, Flemming S, Lock JF, Germer CT, Wiegering A. Changes in appendicitis treatment during the COVID-19 pandemic - A systematic review and meta-analysis. Int J Surg. 2021 Nov;95:106148. doi: 10.1016/j.ijsu.2021.106148.
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Copyright (c) 2024 Danillo Gondim da Silva Filho , Daiana Bettanin de Melo Alexandrino , Júlia Ferreira Junqueira , Joaquim Adriano Antunes de Almeida , Guilherme Augusto Santana Silva, Ana Paula Mendes Macedo Trigueiro , Caroline da Silva Moreira, Gabriela de Freitas Ribeiro , Thiago Arruda Prado Cavalcante , Guilherme Guimarães de Paula Poleto , Renata de Paula Ribeiro Dechichi , Ana Beatriz Ianovali Pera, Fernanda de Queiroz Albuquerque