Postoperative Outcomes After Single or Multiple Visits for Paediatric Appendicitis

AIM: To compare the postoperative outcomes in children with appendicitis diagnosed at the first visit versus after multiple visits overall and among children with complicated appendicitis. METHODS: We identified children aged < 15 years diagnosed with appendicitis between 2018 and 2023. Children were classified as having a single visit (SV) or multiple visits (MV) and in those with and without complicated appendicitis. RESULTS: Of 739 children with appendicitis, 614 (83%) were in the SV group versus 125 (17%) in the MV group. Complicated appendicitis occurred in 28% (95% CI, 25-32) and 36% (95% CI, 28-45), respectively (p = 0.074). The median number of operations was 1 in both groups (p = 0.327), and median hospitalization was 2 days in both groups (p = 0.061). Among 217 children with complicated appendicitis, 172 (79%) were in the SV group and 45 (21%) in the MV group. The median number of operations was 1 in both groups (p = 0.586), while median hospitalization was 5 versus 6 days, respectively (p = 0.196). CONCLUSION: Complicated appendicitis was more frequent after multiple visits, but diagnosis after multiple visits was not associated with more operations or longer hospitalization. For selected children, observation and planned reassessment may be a reasonable alternative to extensive investigations.