Analysis of the results of using the Pediatric Appendicitis Score in the differential diagnosis of abdominal pain in children aged 5–17 years

Acute nonspecific abdominal pain in children is the most common problem requiring differential diagnosis with acute appendicitis. Scales for integrated assessment of individual symptoms and their combinations have been proposed and are constantly being developed that allow predicting the likelihood of acute appendicitis. Purpose to assess diagnostic value of Pediatric Appendicitis Score (PAS) in groups of children in different ages. Materials and methods. 374 children aged 4 to 15 years with acute abdominal pain were evaluated in prospective randomized blinded study. Statistical analysis: ROC – curves, specificity and sensitivity, positive and negative predictive values; Kullback criteria; logistic regression analysis; discriminant analysis. Results. Detection frequency and diagnostic significance of the PAS scale predictors as well as obtained results by using the Pediatric Appendicitis Score depend on children age significantly. In terms of diagnosis of acute appendicitis, the PAS scale shows the best results in older children. Conclusions. Results of Pediatric Appendicitis Score depend on children ages due to different diagnostic value of predictors used in the PAS scale. Pediatric surgeons should keep in your mind these data. Modification of the scale is required taking into account the patient’s age. Further analysis of the issue of PAS using is needed. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. The authors declare no conflicts of interests. Key words: acute appendicitis, children, diagnosis, PAS scale.

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Positive predictive value of Carnett’s sign in differential diagnosis of chronic abdominal pain: a retrospective cohort study

Journal of Pain ◽

10.1016/j.jpain.2013.01.043 ◽

2013 ◽

Vol 14 (4) ◽

pp. S8 ◽

Cited By ~ 1

Author(s):

H. Wang ◽

S. Gross

Keyword(s):

Differential Diagnosis ◽

Cohort Study ◽

Abdominal Pain ◽

Positive Predictive Value ◽

Retrospective Cohort Study ◽

Predictive Value ◽

Retrospective Cohort ◽

Chronic Abdominal Pain ◽

Carnett’S Sign

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Huge retrovesical hydatid cyst with pelvic localization as the primary site: a case report

Acta Radiologica ◽

10.1080/02841850701422138 ◽

2007 ◽

Vol 48 (8) ◽

pp. 918-920 ◽

Cited By ~ 2

Author(s):

A. M. Halefoglu ◽

A. Yasar

Keyword(s):

Differential Diagnosis ◽

Abdominal Pain ◽

Case Report ◽

Hydatid Cyst ◽

Cystic Mass ◽

Primary Site ◽

Cystic Disease ◽

The World ◽

Indirect Hemagglutination ◽

Indirect Hemagglutination Test

We present a patient with symptoms of abdominal pain and frequent urination due to a huge mass in the retrovesical region. All imaging modalities revealed a cystic mass containing small daughter cysts located between the urinary bladder and rectum. Its characteristics led us to suspect the presence of a hydatid cyst, and an indirect hemagglutination test for Echinococcus granulosus was found positive. No other involvement of hydatid cystic disease was detected. The primary site for the hydatid disease was therefore regarded as the pelvis, on which only a few cases have been reported previously. The patient started albendazole therapy, but refused operation. Hydatid cyst should always be considered in the differential diagnosis of abdominopelvic masses in endemic regions of the world.

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Irritable Bowel Syndrome with Constipation

10.2310/gastro.5444 ◽

2015 ◽

Author(s):

Loni Tang ◽

Brooks D. Cash

Keyword(s):

Irritable Bowel Syndrome ◽

Differential Diagnosis ◽

Abdominal Pain ◽

Digital Rectal Examination ◽

Recurrent Abdominal Pain ◽

Differential Diagnoses ◽

Rectal Examination ◽

Stool Form ◽

Alarm Features ◽

Irritable Bowel

Irritable bowel syndrome (IBS) is characterized by recurrent abdominal pain or discomfort that has occurred at least 3 days per month in the 3 months prior to diagnosis. One of the subtypes of this disorder is IBS with constipation (IBS-C), where individuals experience hard or lumpy stools at least 25% of the time and loose or watery stools less than 25% of the time with defecation. This review addresses IBS-C, detailing the epidemiology, etiology, pathophysiology and pathogenesis, diagnosis, differential diagnosis, treatment, and prognosis. A figure shows the Bristol stool form scale. Tables list IBS subtypes, components of digital rectal examination, differential diagnoses for IBS and IBS-C, alarm features, and the American College of Gastroenterology Recommendations. This review contains 1 highly rendered figure, 6 tables, and 71 references.

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Calprotectin (S100 A8/A9) and TNF-alpha in differential diagnosis of chronic abdominal pain in children

Diagnostyka Laboratoryjna ◽

10.5604/01.3001.0013.7957 ◽

2017 ◽

Vol 53 (1) ◽

pp. 5-10

Author(s):

Stanisław Pieczarkowski ◽

Kinga Kowalska-Duplaga ◽

Andrzej Wędrychowicz ◽

Krzysztof Fyderek ◽

Przemko Kwinta ◽

...

Keyword(s):

Differential Diagnosis ◽

Abdominal Pain ◽

Functional Gastrointestinal Disorders ◽

Fecal Calprotectin ◽

Chronic Abdominal Pain ◽

Tnf Alpha ◽

Gastrointestinal Disorders ◽

Control Group ◽

Healthy Children ◽

Inflammatory Bowel

Introduction: Chronic abdominal pain in children is a very frequent and sometimes challenging diagnostic issue. Differential diagnosis in that cases is difficult and often connected with numerous, time-consuming, expensive, and frequently stressful diagnostic studies. The aim of the study was to establish whether fecal calprotectin concentration (FCC) and TNF-alpha may be useful in children with chronic abdominal pain to differentiate between inflammatory bowel disease (IBD), other inflammatory gastrointestinal disorders, and functional gastrointestinal disorders. Methods. The study included patients (median age 13 years), who were assigned to functional gastrointestinal disorders group (n=33); inflammatory gastrointestinal disorders other than IBD (n=71), children with IBD (n=37) and 22 healthy children served as a control group. The concertation of FCC and TNF-alpha in stool samples was measured using ELISA. Results: In healthy children and in children with functional disorders FCCs were below 100 μg/g. In patients with IBD FCCs and TNF-alpha were markedly elevated as compare to children with functional gastrointestinal disorders, however using ROC discrimination of IBD patients was significantly better using FCC than TNF-alpha. Conclusion: FCC is better test for differentiation between IBD, other inflammatory gastrointestinal disorders, and functional gastrointestinal disorders as compare to TNF-alpha concentration in stool. FCC as screening test in patients with chronic abdominal pain should allow to diminish unnecessary diagnostic in cases of functional gastrointestinal disorders.

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An unusual presentation of late oesophagojejunal anastomotic leak after total D2 gastrectomy

Annals of The Royal College of Surgeons of England ◽

10.1308/003588412x13171221589450 ◽

2012 ◽

Vol 94 (2) ◽

pp. e106-e108

Author(s):

AR Verma ◽

VM Patel ◽

S Mikhail ◽

E Zacharakis

Keyword(s):

Differential Diagnosis ◽

Abdominal Pain ◽

Anastomotic Leak ◽

Epigastric Pain ◽

Unusual Presentation ◽

D2 Gastrectomy ◽

Post Operative Period

Oesophagojejunal anastomotic leak usually presents in the early post-operative period with abdominal pain and sepsis. We report a case of late anastomotic leak presenting as epigastric pain with hyperamylasaemia and discuss the differential diagnosis.

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Haemorrhagic Corpus Lutem Mimic Appendicitis

Bangladesh Medical Journal ◽

10.3329/bmj.v37i2.3596 ◽

1970 ◽

Vol 37 (2) ◽

pp. 66-67

Author(s):

Hasina Afroz ◽

Rabeya Akhter ◽

Shahela Jesmin

Keyword(s):

Differential Diagnosis ◽

Abdominal Pain ◽

Corpus Luteum ◽

Ovarian Tumor ◽

Rare Complication ◽

Lower Abdominal Pain ◽

Lower Abdomen ◽

Key Word ◽

Reproductive Life ◽

Chocolate Cyst

Haemoperitoneum secondary to ruptured corpus luteum is a rare complication for women of reproductive life. The differential diagnosis of hemoperitoneum includes various types of acute abdomen that usually associated with acute lower abdominal pain and swelling lower abdomen. The differential diagnosis includes ruptured ectopic pregnancy, ruptured chocolate cyst, twisted ovarian tumor, pelvic inflammatory disease and pelvic peritonitis. Ruptured hemorrhagic corpus luteum is an uncommon cause of acute abdomem. Its occurrence is unknown but is likely quite frequent and without symptoms. Most cases are self limiting; enquire only observation with abdominal pain relieved with analgesics. Some need laparoscopy or laparotomy to achieve homeostasis if the patient is haemodynamically unstable. Key word: Haemoperitoneum, Appendicitis, Ruptured Corpus luteum. DOI: 10.3329/bmj.v37i2.3596 Bangladesh Medical Journal 37(2) 2008 66-67

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Signs and Symptoms in Pediatrics

10.1542/9781581108552 ◽

2015 ◽

Keyword(s):

Differential Diagnosis ◽

Abdominal Pain ◽

Back Pain ◽

Sleep Disturbances ◽

Signs And Symptoms ◽

Diagnostic Procedures ◽

Heart Murmurs ◽

Physical Examinations ◽

Ongoing Care

This convenient handbook is a comprehensive guide to the evaluation and treatment of more than 80 signs and symptoms. It is organized alphabetically, and each entry includes history and physical examinations; causes; differential diagnosis; diagnostic procedures; treatment approaches including when to refer and when to admit; ongoing care and follow-up; and prevention. Contents include: Abdominal pain Anxiety Back pain Chest pain Depression Diarrhea and steatorrhea Dizziness and vertigo Fatigue and weakness Fever Headache Heart murmurs Jaundice Rash Red eye/pink eye Sleep disturbances Speech and language concerns Vomiting Wheezing And more!

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Irritable Bowel Syndrome with Diarrhea

10.2310/gastro.5445 ◽

2018 ◽

Author(s):

Judy Nee ◽

Jacqueline L. Wolf

Keyword(s):

Irritable Bowel Syndrome ◽

Differential Diagnosis ◽

Abdominal Pain ◽

Treatment Options ◽

Clinical Manifestations ◽

Signs And Symptoms ◽

Treatment Modalities ◽

Dietary Advice ◽

Emerging Therapies ◽

Irritable Bowel

Irritable bowel syndrome (IBS) is a complex, functional gastrointestinal condition characterized by abdominal pain and alteration in bowel habits without an organic cause. One of the subcategories of this disorder is IBS with diarrhea (IBS-D). Clinically, patients who present with more than 3 months of abdominal pain or discomfort associated with an increase in stool frequency and/or loose stool form are defined as having IBS-D. This review addresses IBS-D, detailing the epidemiology, etiology and genetics, pathophysiology and pathogenesis, diagnosis, clinical manifestations and physical examination findings, differential diagnosis, treatment, emerging therapies, complications, and prognosis. Figures show potential mechanisms and pathophysiology of IBS, IBS-D suspected by clinical assessment and Rome III criteria, pharmacologic and nonpharmacologic treatment options, potential mechanisms of action of probiotics, and potential treatment modalities. Tables list the Rome criteria for IBS, alarm signs and symptoms suggestive of alternative diagnoses, IBS criteria, differential diagnosis of IBS-D, dietary advice options for IBS-D, and alternative and emerging therapies in IBS-D. This review contains 5 figures, 6 tables and 42 references KEYWORDS: IBS-D, eluxadoline, rifaximin, probiotics, bloating, antidepressants, bile acid malabsorption, microscopic colitis, celiac

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APPENDECTOMY IN CHILDREN WITH ACUTE RHEUMATIC FEVER

PEDIATRICS ◽

10.1542/peds.43.4.573 ◽

1969 ◽

Vol 43 (4) ◽

pp. 573-577

Author(s):

Jer-Shoung Lin ◽

Ramon Rodriguez-Torres

Keyword(s):

Differential Diagnosis ◽

Abdominal Pain ◽

Acute Appendicitis ◽

Rheumatic Fever ◽

Acute Rheumatic Fever ◽

Laboratory Data ◽

Initial Symptom ◽

C Reactive Protein ◽

Reactive Protein ◽

The Right

Clinical and laboratory data on five patients with appendectomy, later proved to have acute rheumatic fever, are presented in detail. The findings indicate that abdominal pain simulating acute appendicitis can be presented as the only initial symptom in acute rheumatic fever. Awareness and knowledge of the presence of clues-high fever, rapid sedimentation rate, prolonged P-R interval, and 4 plus C-reactive protein-usually help to make the differential diagnosis. However, if doubt remains, the right approach is to go ahead with surgery since these patients tolerate anesthesia and laparotomy very well.

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