Unlabelled: Összefoglaló. Bevezetés: A COVID-19-pandémia miatt a gyermekkori appendicitisek kezelésében számos változás történt (laparoszkópia helyett nyílt műtét, antibiotikumkezelés). Világszerte emelkedett a szövődményes appendicitisek aránya. Célkitűzés: Munkánk során a COVID-19-járványnak a gyermekkori akut appendicitisekre kifejtett hatását szerettük volna vizsgálni: lett-e több perforált eset? Módszerek: A 2012 és 2020 között akut vakbélgyulladás miatt operált gyermekeket vizsgáltuk, külön, havi bontásban a 2020-as eseteket. A szövettani diagnózis alapján perforált és nem perforált appendicitis csoportokat alkottunk. A 2020-ban operált betegek COVID-19-statusát is rögzítettük. Statisztikai analízisre a khi2-próbát ('chi2 test for trend') és a Fisher-féle egzakt tesztet alkalmaztuk. Eredmények: A vizsgált időszakban 1343 appendectomia történt, többségében nem perforált akut appendicitis miatt (1166/1343). 2015-től kezdődően a perforált esetek aránya szignifikáns emelkedést mutat (p = 0,0002). Az igazoltan COVID-19-pozitív betegek között magasabb volt a perforáltak aránya (5/8), mint az igazoltan negatív betegek között (15/92) (p = 0,0075). Megbeszélés: A nemzetközi trendeknek megfelelően 2020-ban osztályunkon is magasabb volt a perforált appendicitisek aránya, mint a korábbi években. Ez az emelkedés 2015-től tart, a pandémiával nem mutat szoros összefüggést. A perforált appendicitisek COVID-19-pozitív betegek között észlelt magas arányának okát nem ismerjük. Következtetés: További vizsgálat indokolt annak feltárására, hogy mi okozza a perforált appendicitisek COVID-19-pozitív betegek között észlelt magas, illetve 2015 óta emelkedő rátáját. Orv Hetil. 2021; 162(16): 608-610.
Introduction: As a result of the COVID-19 pandemic, the management of paediatric appendicitis has changed (open instead of laparoscopic appendectomy, antibiotic treatment). The number of complicated appendicitis cases increased worldwide.
Objective: Our aim was to study the effect of the COVID-19 pandemic on paediatric acute appendicitis: has there been more perforated cases?
Methods: Children operated because of acute appendicitis between 2012 and 2020 were studied. Cases from the year 2020 were analysed monthly. Patients were divided into perforated and non-perforated appendicitis groups according to their histological findings. COVID-19 status of patients in 2020 was studied. Chi2 test for trend and Fisher's exact test were used for statistical analysis.
Results: In the study period, 1343 appendectomies were performed. The majority of our cases were non-perforated (1166/1343). The rate of perforated appendicitis cases has been increasing from 2015 (p = 0.0002). The number of perforated cases was higher in COVID-19 positive patients (5/8) then in negative ones (15/92) (p = 0.0075).
Discussion: In line with the international trend, more perforated appendicitis cases were treated in our departement in 2020. However, this increase started in 2015, and there is no correlation with the COVID-19 pandemic. The cause of the increased number of perforated cases in COVID-19 positive appendicitis patients is unknown.
Conclusion: The causes of the high proportion of perforated cases in COVID-19 positive patients and the rising rate of perforated appendicitis cases since 2015 need further studies. Orv Hetil. 2021; 162(16): 608-610.
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