ArticleTherapeutics and clinical risk management2017
Diagnostic reliability of pediatric appendicitis score, ultrasound and low-dose computed tomography scan in children with suspected acute appendicitis.
Article in Therapeutics and clinical risk management, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Appendicitis inflammatory response versus pediatric appendicitis score for grading disease severity in children.Scientific reports · 2026Observational
- Evaluation of copeptin as a marker for the diagnosis of acute appendicitis in children.European journal of pediatrics · 2025Observational
- Validation and Comparison of Pediatric Appendicitis Scores and Management Strategies (Project SPASMS): Protocol for a Prospective Multicenter Observational Study.JMIR research protocols · 2025Article
- Acute Abdominal Pain with Obstructing Trichobezoar: A Pediatric Case of Rapunzel Syndrome Diagnosed in a Pediatric Emergency Department.Pediatric reports · 2025Article
- Review
- Pediatric Appendicitis Score and Ultrasound in children with Acute Appendicitis: An Observational Study.JNMA; journal of the Nepal Medical Association · 2025Observational
- The importance of Galectin-3 in the diagnosis of childhood acute appendicitis.Turkish journal of medical sciences · 2025Article
- Accuracy Evaluation of Pediatric Appendicitis Scoring (PAS) Method in Differentiating Nonspecific Abdominal Pain from Appendicitis.International journal of preventive medicine · 2023Article
- Pediatric appendicitis in the time of the COVID-19 pandemic: A retrospective chart review.Journal of the American College of Emergency Physicians open · 2022Article
- Pre-Coronavirus Disease 2019 Pediatric Acute Appendicitis: Risk Factors Model and Diagnosis Modality in a Developing Low-Income Country.Pediatric gastroenterology, hepatology & nutrition · 2022Article
- Computed tomography scan usage when US results are non-diagnostic for suspected acute appendicitis in children.Medicine · 2020Article
- Paediatric abdominal pain in the time of COVID-19: a new diagnostic dilemma.Journal of surgical case reports · 2020Article
- To determine validity of ultrasound in predicting acute appendicitis among children keeping histopathology as gold standard.Annals of medicine and surgery (2012) · 2019Article
- Different Clinical Features and Lower Scores in Clinical Scoring Systems for Appendicitis in Preschool Children: Comparison with School Age Onset.Pediatric gastroenterology, hepatology & nutrition · 2018Article
- Retrospective Multivariate Analysis of Data from Children with Suspected Appendicitis: A New Tool for Diagnosis.Emergency medicine international · 2018Article
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4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundDiagnosis of appendicitis in children is clinically challenging. Computed tomography (CT) is the gold standard for diagnosis; however, radiation exposure early in life is a concern with this technique. Therefore, in this study, we aimed to evaluate the diagnostic reliability of low-dose CT, pediatric appendicitis score (PAS), and abdominal ultrasound (US) in children with acute appendicitis, to reach a safe diagnosis. PATIENTS AND
methodsThis retrospective study was conducted on 140 children who were admitted with clinically suspected acute appendicitis (45 with positive appendicitis and 95 children with negative appendicitis). Low-dose CT was performed, and PAS was retrospectively calculated for all subjects. US was initially performed for 38 subjects. All results were compared with the final diagnosis reached by an operative, histopathological analysis and follow-up.
resultsLow-dose CT showed a sensitivity, specificity, and accuracy of 97.8%, 100%, and 99.3%, respectively. At a cutoff value ≥5, PAS showed a sensitivity, specificity, and accuracy of 95%, 84%, and 89%, respectively. Abdominal US examination showed sensitivity, specificity, and accuracy of 55.6%, 85%, and 71%, respectively. Implementing Poortman's model resulted in higher accuracy (92%) of US. There was a significant difference in accuracy between a low-dose CT and PAS on one side and between Poortman's model and US examination on the other side. A diagnostic scheme was suggested using PAS as the excluding tool (PAS ≤2 send home and ≥7 send directly to operation) followed by US examination and reserving low-dose CT for inconclusive cases. This scheme would eliminate the use of CT for at least 33.7% and in 7 cases who had initial US examination.
conclusionAlthough CT remains the most accurate and less operator-dependent diagnostic tool for pediatric appendicitis, the radiation hazards could however be minimized using PAS as an excluding tool and US as the primary imaging modality followed by low-dose CT for inconclusive cases only.
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