Why the study?
Classic symptoms of acute appendicitis are uncommon and often misinterpreted in pediatric patients, which can delay diagnosis and lead to rare sequelae.
Pericardial disease, including tamponade and effusion, is a rare but important complication of pediatric appendicitis that requires clinical awareness for appropriate management.
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Alerts clinicians to rare pericardial complications in pediatric appendicitis; leaves open whether targeted cardiac evaluation improves outcomes.
BACKGROUND: Classic symptoms of acute appendicitis are well known but are uncommon and often misinterpreted in pediatric patients, potentially delaying diagnosis and resulting in rare sequelae. METHODS: We conducted a comprehensive systematic literature search of case reports detailing pericardial disease as a rare complication of pediatric appendicitis through MEDLINE, Embase, and Cochrane Databases. Inclusion criteria was that the patient must be < 18 years old and present with both pericardial disease and appendicitis. RESULTS: Our search yielded 7 cases with an average age of 10.3 ± 3.9 years old. The cases involved cardiac tamponade, pericarditis, and/or pericardial effusion. Five cases were diagnosed with appendicitis before complicated by pericardial disease. Most cases had an infectious component, but a majority had negative pericardial fluid cultures. Pleural effusion and abdominal abscesses were other common complications of pediatric appendicitis. CONCLUSION: Awareness of this uncommon relationship may have prognostic value as this may facilitate appropriate management of pericardial effusions, tamponade, and/or appendicitis.
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Saha et al. (2020) studied this question.
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