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Original Article

IJMDC. 2021; 5(1): 267-272

Initial presenting signs and symptoms, type of surgical intervention, and postoperative outcome in pediatric abdominal surgical emergencies

Moshabab Saeed Alahmari, Hashim Ali Alghamdi, Bassim Hassan Alsheri, Abdulhadi Moshabbab Alyahya, Fahad Saad Alshahrani, Ali Mohammad Asiri, Abdulelah Hussain Al-Abdullal.


Background: In the pediatric emergency department, the infants and children commonly present with abdominal and gastrointestinal symptoms, and the presenting complaints are age-dependent. Most of the time, these symptoms are not specific and might be harbingers of life-threatening surgical emergency conditions. This study assessed the clinical presentation, postoperative complications, and outcome of pediatric abdominal surgical emergencies.
Methodology: A record based retrospective study was carried out including all infants and children aging from 1 month up to 14 years of age and presented to Emergency department (ED) or Out patient department (OPD) of Abha Maternity and Children Hospital (AMCH). According to OR and hospital records, researchers identified the initial presenting symptoms and signs. They extracted all other relevant clinical data, including the subsequent management and outcome of all children whose undergone abdominal surgical emergency intervention in AMCH.
Results: The study included 272 child cases who were admitted to the hospital from 2014 to 2018. Abdominal pain was the most reported symptom (79%), followed by nausea and vomiting (74%), Blumberg’s sign (52%), and fever (33%). Exact 187 (68.8%) of the children undergoing the surgical intervention within 12 hours of arrival to ED. All surgeries were done under general anesthesia. Laparotomy was the most reported procedure (77.2%). The most common diagnosis is uncomplicated appendicitis (51.8%).
Conclusions: In conclusion, the study revealed that abdominal pain was the most reported symptom, and most pediatric abdominal surgical emergencies were due to infections and obstruction (appendicitis and inguinal hernia). All cases were discharged healthy with no mortalities recorded. Always must be kept in mind that children often have atypical presentations, and directed use of investigations will minimize misdiagnosis.

Key words: Abdominal emergency, surgery, children, infants, clinical features, outcome

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