E u r o S c i C o n C o n f e r e n c e o n
PEDIATRICS
2017
Pediatrics 2017
Volume:3 Issue:4(Suppl)
Journal of Pediatric Care
ISSN 2471-805X
N o v e m b e r 1 3 - 1 4 , 2 0 1 7
L o n d o n , U K
Page 32
Background:
Appendicitis, the most common atraumatic
surgical abdominal disorder among those 2 years or older,
is diagnosed in 1%–8% of children who present to pediatric
emergency departments (ED) with acute abdominal pain.
Appendicitis diagnosis is done by ultrasonography (US)
or computed tomography (CT). CT use and its associated
radiation exposure have been increasing. The aim of this
study is to examine ED evaluation of suspected appendicitis
with focus on imaging modalities and outcomes.
Methods:
Retrospective chart review of children (<18 years)
with suspected appendicitis evaluated at the Emergency
Department (ED) of the American University of Beirut Medical
Center from July 2009 to March 2011. ICD-10 codes for
abdominal pain, appendicitis, and acute appendicitis were
filtered for suspected appendicitis per the attending/resident
note and included.
Results:
A total of 324 children with suspected appendicitis
were included. Over half (N=181, 55.9%) were between the
Evaluation
of suspected
appendicitis in
the emergency
department of a
tertiary care center
in Beirut, Lebanon
El Sayed M, Fares S
Dakessian A and Bashir R
American University of Beirut Medical
Center, Lebanon
J Pediatr Care 2017, 3:4(Suppl)
DOI: 10.21767/2471-805X-C1-003
ages of 12 – 18 years. More patients were females (N= 178,
54.9%). CT was the most common imaging modality (62%).
Only 2% underwent an US and 36% had no imaging at all.
Appendicitis diagnosis was confirmed in 74 patients (22.8%)
by CT scan only. No cases were diagnosed by ultrasound. Most
patients confirmed with appendicitis had an Alvarado score
between 7-9 (60.8%) and PAS score between 4-6 (60.8%).
Symptoms of migration of pain, anorexia, nausea/vomiting and
signs of RLQ tenderness, rebound pain, coughing/hopping/
percussion pain were all significantly different between those
with confirmed appendicitis and those with other diagnoses.
Conclusion:
The prevalence of confirmed appendicitis among
ED patients who were evaluated for suspected appendicitis was
low. Ultrasound was underutilized. Better clinical prediction
rules and increased incorporation of ultrasound are needed in
the evaluation of suspected appendicitis in pediatric patients
in our setting.
em911@aub.edu.lb