| Clinical criteria for diagnosing perforated appendix in pediatric patients. | |
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MedLine Citation:
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PMID: 16871105 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine predictive variables associated with a perforated appendix in pediatric patients with acute appendicitis. METHODS: This is a retrospective, cross-sectional, observational study from a medical center with more than 2000 beds (230 beds in Department of Pediatrics and Pediatric Surgery), with a mean admission of more than 12000 cases and 2200 surgeries per year. The outcome variable was perforated appendix, and the predictive variables included demographic and clinical factors. RESULTS: During a 6-year period, appendectomies were performed on 274 patients ranging in age from 1 to 18 years. Perforated appendix was found in 100 children (36.5%). Predictive factors significantly associated with perforated appendix were age younger than 9 years, abdominal pain of more than 2 days' duration, temperature of more than 37.9 degrees C, peritoneal signs, and erythrocyte sedimentation rate of more than 25 mm/h. Abdominal ultrasound was performed in 89 patients (32%). For perforated appendix, the ultrasound had a sensitivity of 35%, specificity of 98%, positive predictive value of 95%, and negative predictive value of 55%. Indications for an abdominal ultrasound were determined from a scoring system using the predictive variables significantly associated with perforated appendix. CONCLUSION: The use of our proposed scoring system to determine the indications to perform an abdominal ultrasound may prove to assist in deciding treatment (medical vs surgical) for children with perforated appendix. Initial antibiotic treatment followed by interval appendectomy would become a more likely treatment option if our study results can be validated in a prospective study. |
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Authors:
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Yen-Shih Peng; Hung-Chang Lee; Chun-Yan Yeung; Jin-Cherng Sheu; Nien-Lu Wang; Ya-Huei Tsai |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pediatric emergency care Volume: 22 ISSN: 1535-1815 ISO Abbreviation: Pediatr Emerg Care Publication Date: 2006 Jul |
Date Detail:
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Created Date: 2006-07-27 Completed Date: 2006-11-14 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8507560 Medline TA: Pediatr Emerg Care Country: United States |
Other Details:
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Languages: eng Pagination: 475-9 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, ROC. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Appendicitis / diagnosis* Child Child, Preschool Cross-Sectional Studies Female Humans Infant Male Retrospective Studies |
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