Usefulness of CECT Abdomen in the Diagnosis and Treatment of Chronic Appendicitis in Children

Introduction: Chronic pain abdomen of right lower quadrant is quite common in children. but difficult to arrive at a correct diagnosis. Most of the time the clinical diagnosis points at the possibility of chronic appendicitis. Evaluations of these patients by ultrasound is inconclusive. In the study we tried to find out the role of CECT abdomen in the diagnosis and management of chronic appendicitis. Materials and methods: The study was conducted in the Dept.of Surgery, Kalinga Institute of Medical Sciences, Bhubaneswar between from January 2012 to December 2014,included 30 patients presented with chronic RIF pain. Ultrasound abdomen was normal and CECT abdomen was done to exclude appendicular pathology. Based on CECT findings 18 patients were diagnosed as having chronic appendicitis and 12 patients had normal appendix. Results: All the 18 patients of chronic appendicitis had undergone lap.appendicectomy whereas 12 patients with CECT findings of normal appendix were offered conservative treatment. Histopathology correlation with CECT findings revealed evidence of chronic appendicitis in 14, acute in 2 and normal appendix in 2 patients. In the followed up period upto 1 year, one patient persisted to have recurrent pain abdomen in the operated group, whereas 2 patients in the conservative group continued with non specific pain abdomen. Conclusion: Suggested correlation with histopathology and clinical criteria indicates that CECT abdomen can be taken as an useful investigation in diagnosis and management of chronic appendicitis in children.