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Appendiceal outer diameter as an indicator of acute appendicitis in young children

Published:February 03, 2018DOI:https://doi.org/10.1016/j.ajem.2018.01.102
      Acute appendicitis (AA) Appendicitis is the most common cause of abdominal pain requiring surgical intervention in children, with an incidence of approximately 8% [
      • Nordin A.B.
      • Sales S.
      • Nielsen J.W.
      • et al.
      Standardized ultrasound templates for diagnosing appendicitis reduce annual imaging costs.
      ]. The diagnosis of AA is based on clinical history, physical examination, laboratory tests and ultrasound findings [
      • Zouari M.
      • Jallouli M.
      • Louati H.
      • et al.
      Predictive value of C-reactive protein, ultrasound and Alvarado score in acute appendicitis: a prospective pediatric cohort.
      ]. However, this condition is uncommon in pre-school children with a high incidence of complicated appendicitis such as perforation and/or peritonitis, which increase patient morbidity and hospital costs [
      • Marzuillo P.
      • Germani C.
      • Krauss B.S.
      • et al.
      Appendicitis in children less than five years old: a challenge for the general practitioner.
      ,
      • Almaramhy H.H.
      Acute appendicitis in young children less than 5 years: review article.
      ]. Despite the availability of sophisticated diagnostic imaging, the rate of misdiagnosis of acute appendicitis in young children remains very high [
      • Almaramhy H.H.
      Acute appendicitis in young children less than 5 years: review article.
      ]. The aim of this study is to compare two groups of patients, and to identify prehospital predictive factors that may help the diagnosis of AA in children <6 years old.
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      References

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        • Sales S.
        • Nielsen J.W.
        • et al.
        Standardized ultrasound templates for diagnosing appendicitis reduce annual imaging costs.
        J Surg Res. 2018; 221: 77-83
        • Zouari M.
        • Jallouli M.
        • Louati H.
        • et al.
        Predictive value of C-reactive protein, ultrasound and Alvarado score in acute appendicitis: a prospective pediatric cohort.
        Am J Emerg Med. 2016; 34: 189-192
        • Marzuillo P.
        • Germani C.
        • Krauss B.S.
        • et al.
        Appendicitis in children less than five years old: a challenge for the general practitioner.
        World J Clin Pediatr. 2015; 4: 19-24
        • Almaramhy H.H.
        Acute appendicitis in young children less than 5 years: review article.
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