Acute appendicitis is the most common acute abdominal emergency requiring surgical intervention in the pediatric age group. The lifelong risk of acute appendicitis is 7%. It is most prevalent between the ages of 6 and 12 years. Although it has been well‐defined for more than a century, some challenges in its diagnosis still prevail. Adolescents and older children develop appendicitis more often than younger children, and are symptomatically similar to adults. Non‐specific signs and symptoms, inability to exactly describe the symptoms, and challenges during physical examination make diagnosis more difficult in younger children. Several clinical scoring systems have been introduced to increase diagnostic accuracy. The first scoring system was defined by Alvarado in 1986. The second most commonly used system, constructed by Samuel in 2002, is the Pediatric Appendicitis Score (PAS) which was the first system specific to pediatric patients. PAS consists of six clinical and two laboratory parameters (Table ).Patient characteristics vs final diagnosis (n = 288)Appendicitis (n = 128) Mean ± SD or nNo appendicitis (n = 160) Mean ± SD or nAge (years)11.5 ± 3.610.7 ± 3.6Male7786Duration of pain (h) (median)2310PAS componentsFever3745Migration of pain5754Anorexia6592Nausea or vomiting100117Tenderness in RLQ125114Rebound/pain with cough or hopping8760WBC > 10 000/mm311673>75% neutrophils10967PAS7.0 ± 1.44.9 ± 2.2Low risk (≤4)165Medium risk (5–7)7366High risk (8–10)5429PAS, Pediatric Appendicitis Score; RLQ, right lower quadrant; WBC, white blood cells.The key to
Pediatrics International – Wiley
Published: Jan 1, 2018
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