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October 1988

Acute Appendicitis in Diabetic Children

Author Affiliations

Division of Pediatric Surgery Tufts—New England Medical Center 750 Washington St Boston, MA 02111
The Montreal Children's Hospital 2300 Tupper Montreal, Canada H3H 1P3

Am J Dis Child. 1988;142(10):1019-1020. doi:10.1001/archpedi.1988.02150100013001

Sir.—Delayed chemotaxis, microangiopathy, and sensory neuropathy have each been implicated in the inability of adult diabetic patients to control acute inflammation. Experimental studies have demonstrated these same abnormalities in children with juvenile-onset diabetes mellitus, even though an increased susceptibility to infection is generally not apparent in these children. This retrospective analysis was undertaken to determine if juvenile-onset diabetes mellitus alters the course of acute appendicitis.

Patients and Methods.—From July 1959 to June 1983, 19 patients with type I diabetes mellitus underwent operation for acute appendicitis at the Montreal Children's Hospital. Seventeen case reports were suitable for analysis. The patients ranged in age from 4 years 5 months to 18 years, with a mean of 12 years 4 months. The diagnosis of diabetes mellitus had been made from five months to 13½ years (mean, six years ten months) before appendectomy. The presenting symptom was right lower abdominal quadrant pain

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