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Pediatric Appendiceal Perforation Up During COVID-19 Pandemic

TUESDAY, Dec. 8, 2020 -- There was a statistically significant increased rate of appendiceal perforation in children presenting to the emergency department during the early weeks of the COVID-19 pandemic, according to a research letter published online Dec. 4 in JAMA Network Open.

Rick Place, M.D., from the Virginia Commonwealth University School of Medicine in Falls Church, and colleagues assessed the incidence of perforated appendicitis presenting at a pediatric hospital emergency department during the beginning of the COVID-19 pandemic (March 16 to June 7, 2020) versus the same time period the year before.

The researchers found that 90 children were diagnosed with acute appendicitis, and perforation occurred in 39 percent of cases; this compared with 70 cases of acute appendicitis with 19 percent having perforation during the same period in 2019. This represents a 20 percent absolute increase in the incidence of perforated appendicitis between the two years. Furthermore, in 2020, eight children presented with a pelvic abscess that required initial medical management before delayed interval appendectomy, while no children required medical management in 2019.

"Although the reduction in 'unnecessary' emergency care may be welcomed by some, broad avoidance of the emergency department may lead to increased morbidity and mortality in both children and adults," the authors write.

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Posted: December 2020

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