Appendicitis-related acute referrals to Children’s Health Ireland from Non-Specialist Paediatric Surgical Centres

• DOI: 10.1007/s11845-023-03369-8
• Publication Date: 2023-04-21T02:01:57Z
• Authors: Zakya Penny; Sami Abd Elwahab; Brendan O’Connor; Brian Sweeney
• Keywords: Demographics; Surgical emergency

Abstract Background Acute appendicitis is the most common surgical emergency in children. Eighty percent of paediatric appendicectomies are performed by adult general surgeons on an annual basis. The remaining 20% at Children’s Health Ireland (CHI) centres. Occasionally patients transferred from Non-Specialist Paediatric Surgical Centres (NSPSC) for specialised pre-operative or post-operative care. Aim To assess rates and characterise appendicitis-related referrals to CHI Crumlin NSPSC. Methods A retrospective review all transfers between January 2020 December 2021 was performed. Data relating indications transfer, referring hospital level, patient demographics, management, type surgery, length stay (LOS), radiological studies were collected analysed. Results Seventy-two over 2-year period. total 60.9% male, mean age 9 ± 4.3 years, LOS 6.0 2.2 days (range 1–30 days). Nineteen under 5 years age. Seventy-three level 4 Ninety-seven pre-operatively, 25% those pre-operatively had imaging confirming appendicitis. Fifty-five (40/72) 37.5% (15/40) confirmed complicated Twenty (8/40) underwent both ultrasound computerised tomography (CT) centre. 2.7% (2/72) with known co-morbidities. Ninety-two (66/72) appendicectomy. Eight (6/72) managed non-operatively (NOM) — 2 failed NOM, interval Of operatively, 76% (50/66) laparoscopic appendicectomy, 24% (16/66) open. Conclusion majority Centres. It vital maintain this working relationship so that specialist centres available provide care complex patients.