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ORIGINAL ARTICLES  XV CONGRESSO NAZIONALE DELLA SOCIETÀ POLISPECIALISTICA DEI GIOVANI CHIRURGHI


Minerva Chirurgica 2002 June;57(3):341-6

language: English, Italian

Utility of a scoring system in the diagnosis of acute appendicitis in pediatric age. A retrospective study

Impellizzeri P., Centonze A., Antonuccio P., Turiaco N., Cifalà S., Basile M., Argento S., Romeo C.


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Background. Acute appendicitis is the most frequent cause of surgical emergency in pediatric age. The aim of this study has been to evaluate the diagnostic accuracy of a scoring system, retrospectively applied, to the clinical and laboratory parameters in patients with acute appendicitis.
Methods. A group of 156 patients admitted for acute abdominal pain and operated for appendectomy, in the last 3 years, has been included in the study. The mean age was 8.4 years. The modified Alvarado score has been used as scoring system: white count, neutrophil count, fibrinogen level, body temperature, resistance in the right iliac fossa, length of symptoms, nausea/vomiting. The score has been calculated for each patient. They were subdivided into 3 groups. Group I (score 1-4), no admission; Group II (5-6), admission and observation; Group III (7-10), surgery. This subdivision was then compared with the intraoperative notes.
Results. Patients were divided into 3 groups. Group I, 24 patients (15%); Group II, 34 patients (22%); Group III, 98 patients (63%). On the basis of the intraoperative notes 61 patients had acute appendicitis and 95 complicated acute appendicitis. In this last subgroup the score gave a percentage of patients to operate of 90.5%.
Conclusions. With the present work we confirm the utility of a scoring system in the preoperative diagnosis of acute appendicitis and in our opinion it is a useful system for a first, rapid and economic evaluation in the pediatric emergency department.

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