Resumen

BAEZ SANCHEZ, Carmen; JIMENEZ, Hassel Jimmy; DUARTE, Laura  y  MARTINEZ DE CUELLAR, Celia. Treatment and evolution of peritonitis of appendiceal origin in patients under 18 years of age admitted to the Pediatrics service of the Hospital de Clínicas, San Lorenzo - Paraguay. Period 2021-2023. Rev. Inst. Med. Trop. [online]. 2025, vol.20, n.2, pp.10-16. ISSN 1996-3696.  https://doi.org/10.18004/imt/2025.20.2.10.

Introduction: Appendiceal peritonitis is one of the main pediatric surgical emergencies, the prognosis of which depends on early diagnosis and timely treatment. Understanding its local epidemiological behavior allows for guiding interventions that improve clinical outcomes. Objective: The objective of this study was to describe the clinical evolution and epidemiological characteristics of appendiceal peritonitis in pediatric patients hospitalized at the Hospital de Clínicas between 2021 and 2023. Materials and Methods: Observational, descriptive, cross-sectional, and retrospective study. Patients under 18 years of age diagnosed with peritonitis of appendiceal origin were included. Sociodemographic variables, clinical presentation, duration of illness, antimicrobial use, complications, and length of hospital stay were analyzed. Quantitative variables were described using means and standard deviations, and qualitative variables using proportions. Associations were evaluated using the chi-square test. Results: 85 patients were included; Males predominated (68.2%), as did the 10-14 year age group (42.4%). 63.5% of patients came from the Central Department. Abdominal pain was the most frequent symptom (97.6%), followed by vomiting (76.5%) and fever (54.1%). More than half sought medical attention within the first 24 hours (55.3%). The most frequently used antimicrobial regimen was a combination of a third-generation cephalosporin and a nitroimidazole (85.9%). Complications occurred in 14.1% of patients, with sepsis (7.1%) and contiguous pneumonia (5.9%) being the most common. Three patients required intensive care (3.5%). A symptom duration of ≥48 hours was significantly associated with complications (p < 0.0001). Conclusion: Appendiceal peritonitis predominantly affected school-aged males and young adolescents. Delay in seeking medical attention was associated with a higher risk of complications, highlighting the importance of timely diagnosis.

Palabras clave : Peritonitis; Appendicitis; Postoperative complications; Time to treatment; Antibacterial agents.

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