Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children

Yao-Jen Hsu, Yu-Wei Fu, Taiwai Chin, Yao-Jen Hsu, Yu-Wei Fu, Taiwai Chin

Abstract

Background: Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months.

Methods: The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. The medical records including laboratory data, computed tomography scans, pathology reports and operative notes were reviewed.

Results: The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses, as well as postoperative complications were observed between the two groups.

Conclusions: The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.

Keywords: Appendicitis; Fecalith; Seasons.

Conflict of interest statement

All authors declare no conflict of interest in the study.

Figures

Fig. 1
Fig. 1
The total number of AA patients and those who presented with a fecalith each month. The total number of AA cases was higher in summer, but the number of AA patients with a fecalith was relatively the same throughout the year
Fig. 2
Fig. 2
The ratio (0/00) of patients with a diagnosis of enterovirus infection (open source from Taiwan National Infectious Disease Statistics System, Taiwan Centers for Disease Control)

References

    1. Pogorelic Z, Buljubasic M, Susnjar T, Jukic M, Pericic TP, Juric I. Comparison of open and laparoscopic appendectomy in children: a 5-year single center experience. Indian Pediatr. 2019;56(4):299–303. doi: 10.1007/s13312-019-1518-2.
    1. Pogorelić Zenon, Silov Nikica, Jukić Miro, Elezović Baloević Sara, Poklepović Peričić Tina, Jerončić Ana. Ertapenem Monotherapy versus Gentamicin Plus Metronidazole for Perforated Appendicitis in Pediatric Patients. Surgical Infections. 2019;20(8):625–630. doi: 10.1089/sur.2019.025.
    1. Pogorelić Z, Kostovski B, Jerončić A, Šušnjar T, Mrklić I, Jukić M, Jurić I. A comparison of endoloop ligatures and nonabsorbable polymeric clips for the closure of the appendicular stump during laparoscopic appendectomy in children. J Laparoendosc Adv Surg Tech A. 2017;27(6):645–650. doi: 10.1089/lap.2016.0433.
    1. Pogorelić Z, Katić J, Mrklić I, Jerončić A, Šušnjar T, Jukić M, Vilović K, Perko Z. Lateral thermal damage of mesoappendix and appendiceal base during laparoscopic appendectomy in children: comparison of the harmonic scalpel (Ultracision), bipolar coagulation (LigaSure), and thermal fusion technology (MiSeal) J Surg Res. 2017;212:101–107. doi: 10.1016/j.jss.2017.01.014.
    1. Noudeh YJ, Sadigh N, Ahmadnia AY. Epidemiologic features, seasonal variations and false positive rate of acute appendicitis in Shahr-e-Rey. Tehran Int J Surg. 2007;5(2):95–98. doi: 10.1016/j.ijsu.2006.03.009.
    1. Oguntola AS, Adeoti ML, Oyemolade TA. Appendicitis: trends in incidence, age, sex, and seasonal variations in South-Western Nigeria. Ann Afr Med. 2010;9:213–217. doi: 10.4103/1596-3519.70956.
    1. Fares A. Summer appendicitis. Ann Med Health Sci Res. 2014;4(1):18–21. doi: 10.4103/2141-9248.126603.
    1. Wei PL, Chen CS, Keller JJ, Lin HC. Monthly variation in acute appendicitis incidence: a 10-year nationwide population-based study. J Surg Res. 2012;178:670–676. doi: 10.1016/j.jss.2012.06.034.
    1. Jones BA, Demetriades D, Segal I, Burkitt DP. The prevalence of appendiceal fecaliths in patients with and without appendicitis. A comparative study from Canada and South Africa. Ann Surg. 1985;202(1):80–82. doi: 10.1097/00000658-198507000-00013.
    1. Adamidis D, Roma-Giannikou E, Karamolegou K, Tselalidou E, Constantopoulos A. Fiber intake and childhood appendicitis. Int J Food Sci Nutr. 2000;51(3):153–157. doi: 10.1080/09637480050029647.
    1. Burkitt DP, Walker ARP, Painter NS. Dietary fiber and disease. JAMA. 1974;229:1068–1074. doi: 10.1001/jama.1974.03230460018013.
    1. Kaplan GG, Dixon E, Panaccione R, Fong A, Chen L, Szyszkowicz M, et al. Effect of ambient air pollution on the incidence of appendicitis. CMAJ. 2009;181(9):591–597. doi: 10.1503/cmaj.082068.
    1. Addiss DG, Shaffer N, Fowler BS, et al. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol. 1990;132:910–924. doi: 10.1093/oxfordjournals.aje.a115734.
    1. Central Weather Bureau internet site. . Accessed 8 Aug 2019.
    1. Sulu B, Günerhan Y, Palanci Y, Iıler B, Cağlayan K. Epidemiological and demographic features of appendicitis and influences of several environmental factors. Ulus Travma Acil Cerrahi Derg. 2010;16:38–42.
    1. Alder AC, Fomby TB, Woodward WA, Haley RW, Sarosi G, Livingston EH. Association of Viral Infection and Appendicitis. Arch Surg. 2010;145(1):63–71. doi: 10.1001/archsurg.2009.250.
    1. Taiwan National Infectious Disease Statistics System, Taiwan Centers for Disease Control. . Accessed 8 Aug 2019.
    1. Alaedeen DI, Cook M, Chwals WJ. Appendiceal fecalith is associated with early perforation in pediatric patients. J Pediatr Surg. 2008;43(5):889–892. doi: 10.1016/j.jpedsurg.2007.12.034.

Source: PubMed

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