Gahukamble D B, Rakas F S
Department of Pediatric Surgery, Faculty of Medicine, Al Arab Medical University, Benghazi, Libya.
Indian J Pediatr. 1990 Jul-Aug;57(4):545-50. doi: 10.1007/BF02726766.
920 children below the age of 12 years were admitted with complaints of pain in the right lower abdomen and a suspected diagnosis of acute appendicitis. In 720 patients, clinical diagnosis was made and immediate operation was performed. In 644 of them (89.5%) an intraabdominal lesion was found but in 76 (10.5%) no disease was encountered. Rest 200 patients were observed in the ward and progression was noted at regular intervals. Eight of these patients did not improve while on observation and they were operated. Five others did not have acute appendicitis but in them definite medical diagnosis was made. However in remaining 187 observed patients abdominal signs gradually resolved and needed no surgery but no definite diagnosis also could be made. They appeared to have non-specific abdominal pain. The conclusion of the study was that inhospital observation of patients with right lower quadrant abdominal pain and questionable appendicitis upto three days was a safe way to reduce the rate of negative appendicectomies and unnecessary surgical exploration.
920名12岁以下儿童因右下腹痛入院，疑似诊断为急性阑尾炎。其中720例患者进行了临床诊断并立即手术。在这720例患者中，644例（89.5%）发现腹腔内有病变，76例（10.5%）未发现病变。其余200例患者在病房观察，并定期记录病情进展。其中8例患者在观察期间病情未改善，接受了手术。另外5例患者没有患急性阑尾炎，但做出了明确的医学诊断。然而，在其余187例观察患者中，腹部体征逐渐消失，无需手术，但也无法做出明确诊断。他们似乎患有非特异性腹痛。该研究的结论是，对右下腹痛且疑似阑尾炎的患者进行长达三天的住院观察是降低阴性阑尾切除术和不必要手术探查率的安全方法。
