The aim of this paper is to asses the diagnostic accuracy of selected data from the history, physical examination, ultrasound and selected basic laboratory tests in the diagnosis of the causes of abdominal pain, especially appendicitis, in children seen in the emergency outpatient department. The results of treatment of two groups of children (200 patients each) have been compared. All of the children in the tested group received physical examination, a standardized history has been collected. In addition, a blood count and urine analysis were performed for each child as well as the ultrasound of abdominal cavity and pelvis. In the control group the laboratory tests and ultrasound have been done only on a special order of the surgeon. In the tested group comparing to the control group no reduction of negative laparotomies was observed. The reduction of the percentage of the laparotomies performed with a delay and of the frequency of complicated appendicitis was seen. The highest correlation with appendicitis has been shown for the leukocytosis, right iliac fossa pain, positive result of ultrasound, rebound tenderness and loss of appetite. No correlation between elevated body temperature, abnormalities in the urine analysis and appendicitis were shown. The presence of multiple vomiting seemed to lower a chance that the child has appendicitis. The Alvarado/Kalan score seems to enable with a high probability selection of group of children who do not require hospitalization and surgery. The routine use of abdominal ultrasound has increased the number of diagnoses alternative to appendicitis.
Oct 2, 2019
Nov 21, 2012
|ZB-111523||Oct 2, 2019|
Porter,Robert S. (ed -in-chief) Kaplan,Justin L.(senior assistant ed ).