Diagnostic Reliability of Paediatric Appendicitis Score & Ultrasound Scan in Children with Suspected Acute Appendicitis

Abstract

Objective:  To evaluate the efficacy of Paediatric Appendicitis Score and ultrasound scan in the paediatric population. This study evaluates the best predictive measure for diagnosing acute appendicitis.
Methodology: We conducted a prospective observational study on 120 children (02-13 years) in the department of Neonatal and Paediatric Surgery at The Children’s Hospital PIMS, Islamabad, with suspected appendicitis. Each patient was evaluated based on their Paediatric Appendicitis Score and ultrasound findings. We performed open appendectomy under general anaesthesia in patients with Paediatric Appendicitis Score ≥06 or who presented with severe tenderness on cough, TLC more than 10,000/mm3, or positive ultrasound findings.
Results: In our study, the sensitivity and specificity of the Paediatric Appendicitis Score were 92.6% and 72.0%, respectively. Its sensitivity and specificity were 84.09% and 85.71%, respectively, with cutoff ≥6 combined with ultrasound findings. The combined sensitivity and specificity of Paediatric Appendicitis Score <6 and ultrasound were 85.71% and 94.44%, respectively.
Conclusion: Paediatric Appendicitis Score is a useful diagnostic tool for suspected appendicitis in pediatric population. Its efficacy is significantly increased when combined with ultrasound. Combined application of the Paediatric Appendicitis Score with ultrasonography helps to rule out negative appendectomies and reduces complications associated with delayed diagnosis.