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Role of the Primary Care Provider in the Care of Children With Acute Appendicitis: Experiences From a Public Hospital

Jay W. Park, MD
Arch Pediatr Adolesc Med. 1997;151(2):210. doi:10.1001/archpedi.1997.02170390100023.
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I have read with interest the article by Chande and Kinnane1 on the role of the primary care provider (PCP) in expediting care of children with acute appendicitis. A good number of children had been seen at our community hospital emergency department in their early stage of appendicitis and sent home only to return with advanced complication. During the last 21/2-year period, 13 children were admitted to our community hospital with complicated appendicitis (perforated appendicitis with periappendiceal abscess or peritonitis). Only 3 of them were initially evaluated by the PCP and subsequently referred to a surgeon, and among the remaining 10, 7 children (70%) had been seen at the emergency department the previous day. The average hospital stay for these children with complicated appendicitis was 8.5 days (range, 5-18 days). None of them received acceptable preoperative antibiotic treatment, and only 6 children received proper antibiotic therapy during the postoperative


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