Khirallah Mohammad Gharieb, Abdel Ghafar Muhammad Tarek
Departments of Pediatric Surgery, Tanta University, Egypt.
Department of Clinical Pathology, Tanta University, Egypt.
Ann Med Surg (Lond). 2021 Apr 3;65:102274. doi: 10.1016/j.amsu.2021.102274. eCollection 2021 May.
Acute appendicitis in children represents a common problem. Diagnosis may be difficult due to lack of clinical data. Several scoring systems and laboratory investigations are used for diagnosis. This study aimed to build a model for diagnosis of acute appendicitis in children using urinary 5-hydroxyindoleacetic acid (5-HIAA) and pediatric appendicitis score.
This study was conducted on 191 children with suspicion of acute appendicitis. They were divided into two groups A and B. Children were evaluated in group A with pediatric appendicitis score, ultrasound, and CRP. In group B children were evaluated in the same manner of group A plus measuring of 5-HIAA.
mean age was 13.3 ± 5.2 years. The mean duration of symptoms was 2.2 ± 1.4 days. The mean level of urinary 5-HIAA was 43.53 ± 24.05 in appendicitis patients in group B. In group A there were 65 cases who had appendectomy. Seventy-five children were operated in group B. Negative appendectomies were found in 13 and 7 cases in groups A and B respectively. Thirteen cases were readmitted in group A with diagnosis of acute appendicitis while seven cases were readmitted in group B.
This combination of urinary 5-HIAA and pediatric appendicitis score builds a model for diagnosis of acute appendicitis in children. This model improves the accuracy of diagnosis of acute appendicitis, reduces both the incidence of negative appendectomies and the incidence of readmission or missed cases in children.
小儿急性阑尾炎是一个常见问题。由于缺乏临床数据，诊断可能会很困难。有几种评分系统和实验室检查可用于诊断。本研究旨在建立一个使用尿5-羟吲哚乙酸（5-HIAA）和小儿阑尾炎评分来诊断小儿急性阑尾炎的模型。
本研究对191名疑似急性阑尾炎的儿童进行。他们被分为A组和B组。A组儿童通过小儿阑尾炎评分、超声和CRP进行评估。B组儿童以与A组相同的方式进行评估，另外还测量5-HIAA。
平均年龄为13.3±5.2岁。症状的平均持续时间为2.2±1.4天。B组阑尾炎患者的尿5-HIAA平均水平为43.53±24.05。A组有65例进行了阑尾切除术。B组有75名儿童接受了手术。A组和B组分别有13例和7例阴性阑尾切除术。A组有13例因急性阑尾炎诊断再次入院，B组有7例再次入院。
尿5-HIAA和小儿阑尾炎评分的这种组合建立了一个小儿急性阑尾炎诊断模型。该模型提高了急性阑尾炎的诊断准确性，降低了小儿阴性阑尾切除术的发生率以及再次入院或漏诊病例的发生率。
