Acute Appendicitis in Diabetic Children

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