Relative Value of Clinical, Laboratory and Imaging Tools in Diagnosing Pediatric Acute Appendicitis

Gendel, Inna; Gutermacher, Michael; Buklan, Genady; Lazar, Ludwig; Kidron, Debora; Paran, H; Erez, Ilan

doi:10.1055/s-0031-1273702

Cited by 17 publications

(12 citation statements)

References 17 publications

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“…Despite several well‐known limitations such as low visualizability, probability of false‐positive or ‐negative findings in obese children and operator dependence, comprehensive studies have reported both high sensitivity and specificity for US in the diagnosis of appendicitis. Sensitivity and specificity in the literature range between 87 and 100%, and between 15 and 95%, respectively . In the present study, the sensitivity of US alone was 88.2%, while the specificity was 66.7%.…”

Section: Discussionsupporting

confidence: 44%

Integration of radiology and clinical score in pediatric appendicitis

Aydın

Turan

Yurtseven

et al. 2018

Pediatrics International

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Section: Discussionsupporting

confidence: 44%

Integration of radiology and clinical score in pediatric appendicitis

Aydın

Turan

Yurtseven

et al. 2018

Pediatrics International

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“…Similarly, the rate of postoperative infections was comparable between both cohorts (P = .8). Contrary to our findings, previous studies reported that obesity was a risk factor for longer hospitalization and increased rates of postoperative infections in children with PA. 13,24 The main limitation of our study is its retrospective nature. Certainly, a prospective trial using comparable diagnostic algorithms for children with suspected appendicitis would appropriately clarify if PA is more prevalent in children with obesity.…”

Section: Discussionmentioning

confidence: 98%

Increased Incidence of Perforated Appendicitis in Children With Obesity

Blanco

Sandler

Nadler

2012

Clin Pediatr (Phila)

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Based on their clinical impression, the authors hypothesized that children with obesity may more commonly present with perforated appendicitis. Therefore, the authors reviewed their experience from 2008 to 2010 to determine whether obesity affected the clinical presentation of appendicitis. Variables studied were height, weight, use of diagnostic imaging, and clinical findings of appendicitis at presentation. Outcomes assessed were length of stay and complication rate. The study identified 319 patients with appendicitis. Children with obesity were more likely (P = .026) to present with perforation (28/62, 45%) than nonobese patients (78/257, 30%). Neither length of stay nor complication rate was affected by the presence of obesity. The data suggest that children with obesity are more likely to present with perforated appendicitis. This finding suggests that the diagnosis of appendicitis may be more difficult in obese patients or their presentation may be delayed. Practitioners should have heightened awareness in children with obesity and symptoms of abdominal pain.

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“…[14][15][16] At the same time, with higher TLC values in a clinical setting for appendicitis, a complicated form or higher grade of severity is more likely. Misdiagnosis in these subsets of patients are potentially higher putting them at risk if TLC alone is unrealistically depended upon.…”

Section: Discussionmentioning

confidence: 99%

Role of total leukocyte count in diagnosis of pediatric acute appendicitis: effect of antibiotic administration and duration of onset of symptoms

et al. 2017

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Background: Appendicitis is one of the most common pediatric surgical emergencies. The aim of the study is to determine the significance of total leukocyte count (TLC) in diagnosing appendicitis in the present era of rampant and injudicious antibiotic usage, and its relation to the duration of onset of symptoms.Methods: Study population consists of 148 pediatric patients who had confirmed appendicitis and underwent appendicectomy between January 2015 and December 2015. TLC was performed in all these patients as part of the routine work up. The population was categorized as: group I <24hrs, group II 24 to 4hrs and group III >48 hrs, based on symptom duration and group A and B based on antibiotics received or not respectively.Results: 64.9% (n = 96) were males and 35.1% (n = 52) were females. The ages ranged from 2.1 to 12.9 years (mean/SD being 8.3±1.2). The number of patients with elevated TLC was significantly lesser in Group B (62.2%, n = 92) when compared to the group A (37.8%, n = 56) which did not receive antibiotics (P <0.017). Significantly higher number of patients showed rise in TLC if it was done within 24 hours of onset of symptoms (66.6%, n =40).Conclusions: Our study shows that TLC proved more useful if it is performed within 24 hours of the onset of symptoms and is relevant only if antibiotics have not been administered.

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Relative Value of Clinical, Laboratory and Imaging Tools in Diagnosing Pediatric Acute Appendicitis

Cited by 17 publications

References 17 publications

Integration of radiology and clinical score in pediatric appendicitis

Integration of radiology and clinical score in pediatric appendicitis

Increased Incidence of Perforated Appendicitis in Children With Obesity

Role of total leukocyte count in diagnosis of pediatric acute appendicitis: effect of antibiotic administration and duration of onset of symptoms

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