Importance of Pediatric Appendicitis Scoring System and Ultrasonography in the Diagnosis of Acute Appendicitis in Children

Abstract

Objective: Acute abdominal pain is one of the most common reasons for applying to pediatric emergency services. Acute appendicitis is the most common cause of surgery for acute abdominal pain. In our study, we determined the effectiveness of the Pediatric Appendicitis Scoring System and abdominal ultrasonography (USG) in the diagnosis of acute appendicitis. Methods: The study population consisted of patients who applied to the pediatric surgery service, were diagnosed with acute appendicitis, and underwent surgery. The files of the patients were retrospectively analyzed between 01.05.2020 and 01.01.2021, and data were obtained. The study population consisted of 182 patients. Results: A total of 64.8% (n=118) of the cases were male. When the cut-off value was 7 for pediatric appendicitis score (PAS), the sensitivity was 37.3% and the specificity was 75%. The PAS score was found to be higher in those with appendicitis findings (6.01+-1.65) on USG than in those without (4.46+-1.19) (p=0.001). Abdominal tomography was performed in 38 patients, and appendicitis was detected in 27 patients. When the pathology results were examined, complicated appendicitis was detected in 17 cases, and negative appendectomy was performed in 8 cases. Conclusion: Various scoring systems have been developed to diagnose acute appendicitis in children. For the PAS system, different cut-off values were used in different studies. In our study, the relationship between imaging results and PAS was examined because of the low specificity and sensitivity compared with the literature. it may be appropriate to use PAS and USG together for diagnosis.

Keywords

• abdominal pain
• appendicitis
• children
• pediatric appendicitis score
• score