Anhoury P, Briançon S, Vidailhet M, Schmitt M
Service des urgences, hôpital d'Enfants, Vandoeuvre-lès-Nancy, France.
Pediatrie. 1989;44(6):481-6.
Acute abdominal pain (AAP) is one of the most frequent causes of admission to an emergency department of a childrens' hospital. The diagnosis viewed with the most apprehension is acute appendicitis. We present the results of a prospective study on the evaluation of the clinical and paraclinical symptoms generally observed in an AAP, and discuss the benefit of a diagnostic score for acute appendicitis. Twenty-five different diagnoses were observed, the 5 most frequent being: "non specific" (34.2%), constipation (16%), otorhinolaryngological infection (11.6%), gastroenteritis (10.7%) and acute appendicitis (10.5%). The study of 12 symptoms showed an elevated sensitivity for each one (92-50%), but a low positive predictive value (72-12%). Rigid adhesion to a diagnostic score would have led to unnecessary medical examination.
急性腹痛(AAP)是儿童医院急诊科最常见的入院原因之一。最令人担忧的诊断是急性阑尾炎。我们展示了一项前瞻性研究的结果,该研究对AAP中普遍观察到的临床和辅助临床症状进行了评估,并讨论了急性阑尾炎诊断评分的益处。观察到25种不同诊断,最常见的5种是:“非特异性”(34.2%)、便秘(16%)、耳鼻喉感染(11.6%)、肠胃炎(10.7%)和急性阑尾炎(10.5%)。对12种症状的研究表明,每种症状的敏感性都有所提高(92 - 50%),但阳性预测值较低(72 - 12%)。严格遵循诊断评分会导致不必要的医学检查。