Original scientific paper
Clinical and Laboratory Methods in Diagnosis of Acute Appendicitis in Children
Mojca Groselj-Grenc
Stane Repše
Dubravka Vidmar
Metka Derganc
Abstract
Aim To compare the diagnostic accuracy of clinical examination, white
blood cell and differential count, and C-reactive protein as routine tests
for acute appendicitis with that of interleukin-6 (IL-6) and ultrasonography.
Methods Eighty-two children were admitted to the Department of Pediatric
Surgery and Intensive Care, Ljubljana, Slovenia because of suspected
acute appendicitis. Among them, 49 children underwent surgery for
acute appendicitis and 33 had abdominal pain but were not treated surgically
and were diagnosed with non-specific abdominal pain or mesenteric
lymphadenitis on sonography. Clinical signs of acute appendicitis were
determined by surgeons on admission. White blood cell count and differential
and serum concentrations of C-reactive protein and IL-6 were
measured and abdominal ultrasonography was performed.
Results Ultrasonography showed the highest diagnostic accuracy (92.9%;
95% confidence interval [CI], 84.5%-98.0%, Bayes’ theorem), followed
by serum IL-6 concentration (77.6%; 67.1-86.1%, receiver-operating
characteristic [ROC] curve analysis), clinical signs (69.5%; 59.5-79.0%,
Bayes’ theorem), white blood cell count (68.4%; 57.2-78.3%, ROC
curve analysis), and serum C-reactive protein concentration (63.7%;
52.1‑74.3%, ROC curve analysis). Ultrasonography achieved also the
highest specificity (95.2%) and positive (93.8%) and negative (93.3%) predictive values, whereas clinical signs showed the highest sensitivity
(93.9%).
Conclusion Ultrasonography was a more accurate diagnostic method
than IL-6 serum concentration, laboratory marker with the highest diagnostic
accuracy in our study, and hence it should be a part of the diagnostic
procedure for acute appendicitis in children.
Keywords
Hrčak ID:
16446
URI
Publication date:
20.6.2007.
Visits: 2.232 *