Complicated appendicitis in pediatric age group: The challenge of timely identification.

Abstract

Objective: To determine the frequency of factors associated with delayed presentation of complicated appendicitis in pediatric patients. Study Design: Prospective Cross-sectional study. Setting: Department of Pediatric Surgery, Allied Hospital Faisalabad, A Tertiary Care Hospital. Period: 23-08-2024 to 22-02-2025. Methods: Included 60 pediatric patients aged 3–12 years diagnosed with complicated appendicitis. Consecutive sampling was used based on predefined criteria. Data were collected through parental interviews and medical records. Factors analyzed included demographics, clinical presentation, misdiagnosis, mistreatment, socioeconomic barriers, parental refusal, and healthcare access. Results: Most patients (58.3%) were aged 8–12 years, and 63.3% were male. Low socioeconomic status (40.0%), misdiagnosis by physicians (60.0%) and pediatricians (23.3%), mistreatment by quacks (26.7%), and self-medication (35.0%) contributed to delays. Financial constraints (51.7%), parental refusal of surgery (33.3%), lack of awareness (36.7%), and unavailability of pediatric surgeons (36.7%) further delayed diagnosis. Complications included peritonitis (31.7%), perforation (25.0%), abscess/mass (23.3%), and gangrene (20.0%). Postoperative complications and prolonged hospital stays occurred in 28.3%, while 43.3% fully recovered. Conclusion: Delayed presentation of complicated appendicitis in pediatric patients is influenced by misdiagnosis, mistreatment, financial barriers, and healthcare access issues. Early recognition, improved care access, and parental education can reduce morbidity and financial burdens.