Fifth Day Syndrome, also known as Pediatric Post-Appendectomy Fifth Day Syndrome, occurs when a child who has undergone a smooth appendicitis surgery suddenly experiences abdominal pain and high fever 4 to 5 days post-operation (in rare cases, up to the 8th day). Within a few hours, the symptoms may develop into signs resembling diffuse peritonitis.

bubble_chart Clinical Manifestations

Conservative treatment is primarily adopted, and surgery is often unnecessary. Fasting, intravenous fluid replacement, continuous nasogastric decompression, and antibiotics are essential and effective for treating this condition. Importantly, children with appendicitis should generally be discharged only after the sixth day to avoid delayed management of fistula disease or the fifth-day syndrome.

bubble_chart Diagnosis

1. The course of the disease is short, with no signs of true peritonitis.

2. The surgical procedure went smoothly, with no abnormalities observed during and after the operation, and the incision showed no signs of infection.

3. On the 5th postoperative day, sudden abdominal pain, high fever, and signs of peritonitis appeared.

4. Conservative treatment led to rapid symptom relief, and subsequent exploratory laparotomy revealed no abnormalities. {|103|}

bubble_chart Treatment Measures

Conservative treatment is primarily adopted, and surgery is often unnecessary. Fasting, intravenous fluid replacement, continuous nasogastric decompression, and antibiotics are essential and effective for managing this condition. Importantly, children with appendicitis should generally not be discharged before the 6th day to avoid complications such as fistula disease or delayed management of the 5th-day syndrome.