Positive and negative rates in children with acute appendicitis

Abstract EN

Background: Acute appendicitis remains the most misdiagnosed condition worldwide.

Children tend to present with a variety of clinical symptoms, may have difficult communication and could be difficult to examine.

Design: A Retrospective Study.

Setting: King Hamad University Hospital, Bahrain.

Method: One hundred thirty-six patients who had appendectomy were reviewed between 1 May 2012 and 31 March 2016.

The final diagnosis of acute appendicitis was the histological analysis of the excised specimen.

Result: One hundred thirty-six underwent appendectomy and were included in this study between 1 May 2012 and 31 March 2016.

One hundred sixteen (85%) patients had uncomplicated appendicitis and 16 (12%) patients had complicated appendicitis.

Four patients were histologically negative; Negative Appendectomy Rate (NAR) was 2.9%.

Twelve patients had perforation; therefore, the Perforation Rate (PR) was 8.8%.

Sixty-six (49%) laparoscopic appendectomies and 70 (51%) open appendectomies were performed.

There was no significant difference between hospital stay and surgical technique; the average stay was 4.3 days.

Conclusion: Our study has demonstrated NAR of 2.9% for a histologically normal appendix; a perforation rate of 8.8%.

This study revealed the need for a prospective study for the pediatric acute abdomen and a dedicated radiological resource focused on pediatric radiology.

The diagnosis of appendicitis in children remains largely clinical with appropriate use of US.