Pediatric appendicitis score☆
Section snippets
Materials and methods
In the last 5 years, 1,170 children aged 4 to 15 years with abdominal pain suggestive of acute appendicitis at Southampton General Hospital, Southampton and St George's Hospital, London were analyzed prospectively. A uniform prospective data form was completed, which included. (1) demographic data (age and sex); (2) duration of symptoms: (a) anorexia, (b) nausea/vomiting, and (c) migration of pain from umbilical area to right lower quadrant; (3) physical signs: (a) right iliac fossa tenderness
Age and sex
Mean age of patients with appendicitis was 9.9 ± 3.3 versus 11 ± 2.7 years in those without appendicitis (P >.05). Sex ratio (male to female) of children with appendicitis was (471:263) 1.7:1 versus 1.8:1 (281:155) without appendicitis (P >.05). There was a good correlation between the 2 groups regarding age and sex (r = 0.84).
Group 1
Sixty-three percent (734 of 1,170) had appendicitis confirmed by histology. Pathologic stages of acute appendicitis were inflamed, 35% (acute inflammatory infiltrate is
Discussion
PAS specifically addresses symptomatology and physical signs unique to children. Physical signs, such as cough, percussion tenderness, and hopping tenderness in the right iliac fossa had significant correlation and, hence, were assigned as a single variable with a score of 2. Tenderness in the right iliac fossa especially over the McBurney's point in combination with the above physical sign had a good diagnostic index with a high probability of predicting true prevalence of appendicitis (P
Acknowledgements
The author thanks all the Pediatric Surgical Consultants at Southampton General Hospital, Southampton and St George's Hospital, London, for the use of their patients in this study. Special thanks to the Department of Pathology and Microbiology.
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Address reprint requests to Madan Samuel, Department of Pediatric Urology, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, England.