Constipation Faecolith as a Cause for Paediatric Appendicitis - A Retrospective Review from Rural Tertiary Care Centre.

Abstract

Background: Occlusion of the appendiceal lumen by faecolith results in appendicitis and its sequelae, including perforation and gangrenous alterations. A faecolith is believed to be the outcome of constipation. This study assessed the association between constipation faecolith, the occurrence of acute appendicitis and its complications.

Methodology: This study examined the patients in the paediatric surgery department between the ages of 2 and 14 years who were diagnosed with acute appendicitis between January 2022 and January 2024. The study included 79 patients in total. The collected data were analysed using the SPSS software (IBM SPSS 25.0, Chicago, IL, USA.). AChi‑square test was used to find the association between the categorical variables. P < 0.05 was considered statistically significant with a 95% of confidence interval.

Results: A total of 79 patients were admitted during the study period. In that male‑to‑female ratio was 2.3/1. In the present study, 34% (27/79) of patients had a history of constipation, of which 22.8% (18/79) were found to have faecolith in the appendiceal lumen intraoperatively. There was a statistically significant (P < 0.001) association between the history of constipation among patients with appendicitis, appendicitis with faecolith and appendicitis with complications. Patients with a history of constipation had an operational finding of faecolith in the appendiceal lumen that was statistically significant (P < 0.001).

Conclusion: This retrospective study showed that one of the new risk factors for the development of faecolith, which leads to acute appendicitis and its sequelae, is constipation, which may be due to poor diet habits among children. Therefore, when it comes to planning surgery and post‑operative management, the presence of constipation histories and faecolith findings should be taken into consideration.