Appendicitis versus non-specific acute abdominal pain: Paediatric Appendicitis Score evaluation

Arias, Mercedes; Salgado‐Barreira, Ángel; Sánchez, Margarita Montero; Eire, P Fernández; Saavedra, Silvia García; Veiras, Javier Gómez; Lorenzo, José Ramón Fernández

doi:10.1016/j.anpede.2017.01.008

Cited by 5 publications

(6 citation statements)

References 37 publications

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“…Marcos Prada et al . (2018)[ 27 ] showed that CRP was effective in increasing the diagnostic accuracy, which is not consistent with our study. According to their proposal, in addition to using PAS to differentiate NSAP from appendicitis, CRP can be used alongside PAS indicators for diagnosis.…”

Section: Discussioncontrasting

confidence: 84%

“…PAS correctly classified patients into low-risk and a high-risk group for appendicitis, and also the CRP was effective in increasing the diagnostic accuracy. [ 27 ] Our results showed that no significant difference was found between patients with appendicitis and patients with NSAP with respect to temperature, but the tenderness in touching RLQ in the appendicitis group was higher than that in the NSAP groups. The difference between the two studies may be due to different perceptions of pain intensity in different cultures.…”

Section: Discussionmentioning

confidence: 58%

“…Marcos Prada et al . (2018)[ 27 ] examined the usefulness of PAS and CRP in differentiating appendicitis from NSAP. The results showed no difference in temperature and RLQ tenderness between patients with appendicitis and patients with NSAP.…”

Section: Discussionmentioning

confidence: 99%

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Accuracy Evaluation of Pediatric Appendicitis Scoring (PAS) Method in Differentiating Nonspecific Abdominal Pain from Appendicitis

Amiri

Raeisi

Azizi

et al. 2023

International Journal of Preventive Medicine

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Background: This study aimed at evaluating the accuracy of the pediatric appendicitis scoring method in differentiating nonspecific abdominal pain (NSAP) from appendicitis. Methods: This cross-sectional study was conducted on 391 children who were hospitalized in the emergency ward due to acute abdominal pain suspected of appendicitis . Pediatric Appendicitis Score (PAS), C-reactive protein (CRP), and appendicitis pathology results of patients undergoing surgery were recorded. Results: The results showed that the no significant difference was found among patients in the three experimental groups (appendicitis, specific abdominal pain except appendicitis, and NSAP) with respect to temperature ( p = 0.212), but the other variables were significantly different. Findings showed that high CRP frequency, pain migration to right lower quadrant (RLQ), tenderness in right iliac fossa (RIF), anorexia, leukocytosis, high neutrophil, and mean tenderness in RLQ in the appendicitis group were higher than those in the other two groups ( p = 0.001). The PAS questionnaire can also be used as a reliable questionnaire with appropriate sensitivity (0.929) and specificity (0.993), and this questionnaire along with detailed clinical examinations could reduce the rate of negative appendectomy to less than 1%. Conclusions: This study showed high accuracy of PAS in diagnosing children with appendicitis and differentiating appendicitis from cases of NSAP and specific abdominal pain other than appendicitis. The PAS system could also significantly reduce cases of negative appendicitis. Although high CRP had an excellent ability to diagnose appendicitis, its accuracy was lower than PAS.

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Section: Discussioncontrasting

confidence: 84%

Section: Discussionmentioning

confidence: 58%

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Accuracy Evaluation of Pediatric Appendicitis Scoring (PAS) Method in Differentiating Nonspecific Abdominal Pain from Appendicitis

Amiri

Raeisi

Azizi

et al. 2023

International Journal of Preventive Medicine

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“…Patients with MM usually have a good prognosis and life expectancy. The incidence of acute appendicitis associated with SIT or MM is rare, approximately between 0.016 and 0.024% [ 31 , 32 ]. In our review of literature, we could observe a prevalence of this condition in males (68.5% of the examined sample), with a median age for both sexes of 27 years.…”

Section: Discussionmentioning

confidence: 99%

Acute appendicitis and situs viscerum inversus: radiological and surgical approach—a systematic review

et al. 2023

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Introduction Acute appendicitis is one of the most frequent intra-abdominal diseases requiring emergency surgical consult and treatment. The diagnosis of this condition is based on clinical features and radiologic findings. One-third of patients with acute appendicitis present unusual symptoms. There are several circumstances that may cause misdiagnosis and unclear prognostic prediction. Among these, situs viscerum inversus totalis and midgut malrotation can be challenging scenarios, leading to a delay in treatment, especially when these conditions are unknown. We decided to carry on a systematic review of published cases of acute appendicitis in the context of anatomical anomalies. Methods We used the MESH terms “appendicitis” AND “situs inversus” AND/OR “gut malrotation” to search for titles and abstracts. Inclusion criteria were patients with clinical and/or radiological diagnosis of acute appendicitis, with conservative or surgical management and with preoperative/intraoperative findings of situs viscerum inversus or gut malrotation. Additionally, previous reviews were examined. Exclusion criteria of the studies were insufficient patient clinical and demographic data. Results We included in this review 70 articles concerning 73 cases of acute appendicitis with anatomical anomaly. Patients were aged from 8 to 86 years (median: 27.0 years). 50 were male and 23 were female. 46 patients (63%) had situs viscerum inversus, 24 (33%) had midgut malrotation, 2 (2.7%) had Kartagener’s syndrome, one of them (1.4%) had an undetermined anomaly In 61 patients the anatomical anomaly was unknown previously (83.6%), while 16,4% already were aware of their condition. Conclusion Acute appendicitis can occur in association of rare anatomical anomalies and in these cases diagnosis can be challenging. Situs viscerum inversus and midgut malrotation should always be considered in the differential diagnosis of a patient with left lower quadrant pain, especially in younger population. Besides clinical features, it is fundamental to implement the diagnostic progress with radiological examination. Laparoscopic approach is useful to identify and treat acute surgical emergency and it is also a diagnostic tool and can be tailored in order to offer the best exposition of the operatory field for each single case.

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“…The mean leukocyte count in patients with AA was 14,330/mm 3 , and the ratio of 8.4 had 88% sensitivity for the diagnosis of AA. Similarly, Arias et al 14 used the same PAS, consisting of temperature, leukocytes, and neutrophils, with the addition of CRP to increase sensitivity, and found 99% sensitivity for the diagnosis of AA.…”

Section: Discussionmentioning

confidence: 99%

Management of Acute Appendicitis in Children in a University Hospital

Mekitarian Filho,

Horita,

dos Santos

et al. 2023

Pediatr Emer Care

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Objective Little is known about the positive predictive value of diagnostic tools for severe acute appendicitis (AA). Our objective was to study a retrospective cohort of patients with AA, emphasizing its laboratory and radiologic features, to establish risk factors for more severe cases of AA. Methods A retrospective cohort study with patients with AA confirmed by biopsy was performed. In each case, examinations were reviewed, data were compared, and laboratory and radiologic findings were established to identify risk factors for severe AA. Results During the studied period, 405 children, with a mean age of 120 months, were evaluated. Most of the patients were boys (63.2%). C-reactive protein was the best parameter for the diagnosis of perforated AA, with a sensitivity of 88% for values above 173 mg/dL. A total of 64.4% of the patients underwent abdominal ultrasound, and 26% had normal results. Conclusions Acute appendicitis is a disease with a wide spectrum of complications; thus, it is important to recognize the markers associated with severe cases of AA. High levels of C-reactive protein were the best markers associated with perforated appendicitis, and ultrasound was requested in most of the cases but was not helpful in most of them.

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Appendicitis versus non-specific acute abdominal pain: Paediatric Appendicitis Score evaluation

Cited by 5 publications

References 37 publications

Accuracy Evaluation of Pediatric Appendicitis Scoring (PAS) Method in Differentiating Nonspecific Abdominal Pain from Appendicitis

Accuracy Evaluation of Pediatric Appendicitis Scoring (PAS) Method in Differentiating Nonspecific Abdominal Pain from Appendicitis

Acute appendicitis and situs viscerum inversus: radiological and surgical approach—a systematic review

Management of Acute Appendicitis in Children in a University Hospital

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