Pediatric Acute Appendicitis Score in Children With Acute Abdominal Pain (AAP)

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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THE COMPARATIVE ANALYSIS OF ALVARADO AND PAS SCALES IN THE DIFFERENTIAL DIAGNOSTICS OF ACUTE ABDOMINAL PAIN IN CHILDREN

Russian Journal of Pediatric Surgery ◽

10.18821/1560-9510-2019-23-6-309-313 ◽

2020 ◽

Vol 23 (6) ◽

pp. 309-313

Author(s):

Viktor G. Vakulchyk

Keyword(s):

Clinical Trial ◽

Abdominal Pain ◽

Comparative Analysis ◽

Acute Appendicitis ◽

Diagnostic Accuracy ◽

Acute Abdominal Pain ◽

Differential Diagnostics ◽

Current Trends

Introduction. Current trends in the diagnostics of acute appendicitis have the following main objectives: to improve the diagnostic accuracy in destructive forms; to reduce the number of negative appendectomies and diagnostic laparoscopies. Purpose. To compare the effectiveness of Alvarado and PAS scales and to find out which of them is more appropriate in the differential diagnostics of acute abdominal pain in children. Material and Methods. A prospective randomized blind clinical trial was performed. 326 children aged 5-17 years with abdominal pain were examined. Results. No significant advantages of any of the analyzed scales were found in the differential diagnostics of acute abdominal pain in children aged 5-17 years. Both scales can be used in the primary stratification of patients. With the conclusion “Acute appendicitis is likely possible,” the level of non-diagnosed cases of acute appendicitis will not exceed 3%. Conclusions. Further assessment of various scales for the diagnostics of acute appendicitis in children has to be done in order to select the optimal one. The obtained results urge to make scales’ modification so as to improve the diagnostic accuracy and to reduce the number of negative appendectomies and diagnostic laparoscopies.

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Acute Appendicitis Secondary to Appendiceal Endometriosis

Case Reports in Surgery ◽

10.1155/2020/8813184 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

João Paulo Nunes Drumond ◽

André Luis Alves de Melo ◽

Demétrius Eduardo Germini ◽

Alexander Charles Morrell

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Laparoscopic Appendectomy ◽

Clinical Picture ◽

Acute Abdominal Pain ◽

Rare Condition ◽

Vermiform Appendix ◽

Histopathological Analysis ◽

Women Of Childbearing Age ◽

Childbearing Age

Endometriosis in the vermiform appendix is a rare condition that affects women of childbearing age. The clinical picture can simulate inflammatory acute abdominal pain, especially acute appendicitis. Laboratory and imaging tests may assist in the diagnosis but are not conclusive. This article reports a case of acute appendicitis caused by appendiceal endometriosis for which laparoscopic appendectomy and diagnostic confirmation were performed after histopathological analysis.

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Abdominal Pain in the Female Patient: A Case of Concurrent Acute Appendicitis and Ruptured Endometrioma

Case Reports in Surgery ◽

10.1155/2016/2156148 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4

Author(s):

Martine A. Louis ◽

Amanda R. Doubleday ◽

Elizabeth Lin ◽

Ji Yoon Baek ◽

Alda Andoni ◽

...

Keyword(s):

Differential Diagnosis ◽

Abdominal Pain ◽

Acute Appendicitis ◽

Acute Abdominal Pain ◽

Women Of Childbearing Age ◽

Childbearing Age ◽

Common Cause ◽

Surgical Emergencies ◽

Ovarian Endometrioma ◽

General Surgeons

General surgeons are often asked to evaluate acute abdominal pain which has an expanded differential diagnosis in women of childbearing age. Acute appendicitis accounts for many surgical emergencies as a common cause of nongynecologic pelvic pain. In some rare instances, acute appendicitis has been shown to occur simultaneously with a variety of gynecologic diseases. We report a case of concurrent acute appendicitis and ruptured ovarian endometrioma.

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Omental infarction in an obese 10-year-old boy

Pediatric Reports ◽

10.4081/pr.2011.e22 ◽

2011 ◽

Vol 3 (3) ◽

pp. 22 ◽

Cited By ~ 1

Author(s):

Katerina Kambouri ◽

Stefanos Gardikis ◽

Alexandra Giatromanolaki ◽

Aggelos Tsalkidis ◽

Efthimios Sivridis ◽

...

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Preoperative Diagnosis ◽

Acute Abdominal Pain ◽

Accurate Diagnosis ◽

Lower Abdomen ◽

Omental Infarction ◽

Appropriate Treatment ◽

Low Incidence ◽

The Right

Primary omental infarction (POI) has a low incidence worldwide, with most cases occurring in adults. This condition is rarely considered in the differential diagnosis of acute abdominal pain in childhood. Herein, we present a case of omental infarction in an obese 10-year-old boy who presented with acute abdominal pain in the right lower abdomen. The ultrasound (US) examination did not reveal the appendix but showed secondary signs suggesting acute appendicitis. The child was thus operated on under the preoperative diagnosis of acute appendicitis but the intraoperative finding was omental infarct. Since the omental infarct as etiology of acute abdominal pain is uncommon, we highlight some of the possible etiologies and emphasize the importance of accurate diagnosis and appropriate treatment of omental infarction.

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Acute abdominal pain in childhood with special reference to cases not due to acute appendicitis

Journal of Pediatric Surgery ◽

10.1016/0022-3468(69)90726-x ◽

1969 ◽

Vol 4 (3) ◽

pp. 387

Author(s):

J. Lister

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Special Reference ◽

Acute Abdominal Pain

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Acute Abdominal Pain in Childhood, with Special Reference to Cases not due to Acute Appendicitis

BMJ ◽

10.1136/bmj.1.5639.284 ◽

1969 ◽

Vol 1 (5639) ◽

pp. 284-286 ◽

Cited By ~ 32

Author(s):

P. F. Jones

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Special Reference ◽

Acute Abdominal Pain

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Non specific mesenteric adenitis of forty-five cases in childhood and review

Trakia Journal of Sciences ◽

10.15547/tjs.2020.04.014 ◽

2020 ◽

Vol 18 (4) ◽

pp. 396-400

Author(s):

K. Georgiev ◽

Kr. Kalinova

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Acute Abdominal Pain ◽

Laboratory Diagnosis ◽

Daily Basis ◽

Systematic Classification ◽

Mesenteric Lymphadenitis ◽

Common Diagnosis ◽

Mesenteric Adenitis

Mesenteric lymphadenitis is a disease that pediatric surgeons face on a daily basis due to symptoms resembling the symptoms of acute appendicitis. 45 children with abdominal pain were examined for the last 3 years, aged 3 to 18 years, treated non-surgically, and proven laboratory, microbiological and instrumental diagnosis. Mesenteric lymphadenitis is a very common diagnosis in children with suspected acute appendicitis. In previous methods, based solely on age and location, there were many difficulties in identifying the etiology of acute abdominal pain in children. We decided to develop a new systematic classification of acute abdominal pain. Carrying out a clinical and epidemiological analysis of the diseased children with acute surgical diseases in order to establish a pre-operative imaging and laboratory diagnosis, to establish the sensitivity of microbiological markers An overview of the literature on the topic has been made

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A study of correlation between clinical, radiological and pathological diagnosis of appendicitis: a retrospective analytic study

International Surgery Journal ◽

10.18203/2349-2902.isj20183446 ◽

2018 ◽

Vol 5 (9) ◽

pp. 3011

Author(s):

Prabhu R. ◽

Vijayakumar C. ◽

Balagurunathan K. ◽

Senthil Velan M. ◽

Kalaiarasi R. ◽

...

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Scoring System ◽

Acute Abdominal Pain ◽

Histopathological Examination ◽

Tertiary Care ◽

Radiological Finding ◽

Clinical Signs ◽

Emergency Setting ◽

Alvarado Score

Background: Acute appendicitis is the most common cause of acute abdominal pain in young adults requiring emergency surgery. Appendicectomy is the most frequently performed surgery. The diagnosis is often challenging and the decision to operate in an emergency setting is always debatable. A combination of clinical signs and symptoms with laboratory findings in many scoring systems are suggesting the probability of appendicitis and the possible subsequent management pathway. The aim was to evaluate accuracy of the clinical Alvarado scoring system, radiological finding and histopathological examination for the diagnosis of acute appendicitis.Methods: A retrospective study was conducted in the department of general surgery in a tertiary care centre in South India. Total of 237 patients with acute abdominal pain were included and evaluated with the clinical Alvarado scoring system, radiological finding with (USG/CT abdomen) and histopathological examination for the diagnosis of acute appendicitis. The data was collected and analyzed retrospectively.Results: Of the 237 patients, 164 patients were male (69.1%) and rest is female. The correlation of the Alvaroda score with histopathological findings in groups with score > 7 and ≤7 the correlation of Alvarado score and the ultrasound findings were comparable between the study groups. The sensitivity of ultrasound in diagnosing acute appendicitis in patients with Alvarado score >7 was 72.99%. The sensitivity of ultrasound in diagnosing acute appendicitis in patients with Alvarado score ≤7 was decreased to 27%.Conclusions: The diagnostic accuracy of clinical features is far better than radiological investigations in the diagnosis of acute appendicitis. Therefore, it is concluded that it is better to use radiological investigations only to confirm the diagnosis of acute appendicitis rather to diagnose it.

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