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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