Çocuk Acil Servisinde Akut Apandisit Tanisi İçin Pediatrik Apandisit Skorlamasinin ve Ultrasonografi Bulgularinin Değerleri The Importance of the Pediatric Appendicitis Score and Ultrasonographic Findings for the Diagnosis of Acute Appendicitis in the Pediatric Emergency Department

Objective: Acute appendicitis is an emergency surgical disorder that is common in the pediatric population but the diagnosis may be difficult. We aimed to investigate the pediatric appendicitis score (PAS) and ultrasonographic (US) findings in the diagnosis of acute appendicitis. Material and Methods: A total of 220 children aged 2 to 18 years who had presented to the pediatric emergency department with acute abdominal pain and thought to have acute appendicitis with the history and physical examination findings were included in this prospective study. All pediatric appendicitis scores were assigned by the same physician. An outside appendix diameter of 6 mm or more on US was considered abnormal. Based on the histopathological findings, two groups were defined as the acute appendicitis group and other medical conditions group. The scoring system and US results were compared between the two groups. Results: Ninety-three (42.3%) of the 220 patients admitted with a diagnosis of acute appendicitis underwent surgery. Eighty-one (87.1%) surgical group patients had acute appendicitis histopathologically. The median PAS of patients that had acute appendicitis was 8 (1-10) while the median of the other group was 3 (0-9) (p=0.001). The sensitivity of PAS was 58.0% with a specificity of 94.9%. There were 43 patients (19.5%) who had appendicitis on US with a clinical score of 8 or more. The sensitivity was 44.4% and the specificity was 94.9% in cases that were both score and US positive. 1