КЛІНІЧНЕ ТА МОРФОПАТОЛОГІЧНЕ ЗНАЧЕННЯ АПЕНДИКОЛІТІВ У ПЕРЕБІГУ ГОСТРОГО АПЕНДИЦИТУ У ДІТЕЙ

Appendicoliths are clinically significant in pediatric acute appendicitis, potentially predisposing to more severe inflammatory and destructive changes of the vermiform appendix. Objective: To assess the incidence of appendicoliths in children undergoing surgery for acute appendicitis and to evaluate their clinical significance in relation to intraoperative and histopathological findings and disease severity. Materials and Methods: This retrospective study included 1,050 children who underwent appendectomy between 2018 and the first half of 2026, comprising 750 open and 300 primary laparoscopic procedures. Clinical, imaging, intraoperative, microbiological, and histopathological data were analyzed, focusing on the presence of appendicoliths and their association with inflammatory and destructive appendiceal changes. Collected data were systematized and analyzed using descriptive statistical methods. Categorical variables were presented as absolute (n) and relative (%) frequencies. Data processing and study conduct adhered to strict confidentiality, anonymization, personal data protection protocols, and ethical standards for biomedical research. This study was conducted as part of the institution’s scientific research activities without external funding or grant support. Results: Histopathological examination identified appendicoliths in 99 patients (9.43%). Of these, 82 patients (7.81% of the entire cohort) exhibited acute appendicitis associated with an appendicolith, whereas 17 patients (1.62%) presented with an appendicolith but no histopathological evidence of acute inflammation. Appendicolith-associated cases frequently demonstrated severe inflammatory and destructive changes. Intraoperative findings included periappendicular abscesses and suppurative peritonitis; histopathological analysis revealed predominantly phlegmonous and ulcero-phlegmonous forms, accompanied by microperforation and gangrenous changes Several cases exhibited segmental inflammatory involvement and progression toward transmural destruction. A history of recurrent abdominal pain was also frequently documented. Conclusions: Appendicoliths constitute a significant morphological finding in pediatric acute appendicitis, correlating with complicated inflammatory and destructive changes. Their identification offers predictive potential for assessing disease severity and informing therapeutic decision-making. Accurate diagnosis, risk stratification, and individualized management of pediatric acute appendicitis require the integration of clinical, imaging, intraoperative, and histopathological findings.