Appendiceal Rupture
During a five-year period, 944 patients with appendicitis were reviewed at the Columbus (Ohio) Children's Hospital. It was found that within the subgroup with perforation (41%) the incidence was related to age (less than 2 years, 93%; 3 to 5 years, 71%; 6 to 10 years, 40%; greater than 10 years, 33%). However, in addition, a substantial number of patients with appendiceal rupture had been seen prior to rupture by a physician who failed to diagnose appendicitis, because the patients often had histories less suggestive of appendicitis. The evidence in some patients suggested inadequate evaluation. Previous recorded findings that were not acted upon included abdominal rigidity, abdominal mass, and abnormal rectal examination.
