The Association Between the Intensity of Abdominal Pain and a Diagnosis of Acute Appendicitis in Children.

Abstract

Background: Acute appendicitis is the most common surgical etiology for acute abdominal pain in children. In this study, we examine whether there is a correlation between the intensity of abdominal pain, measured by the Visual Analogue Scale (VAS), and acute appendicitis. Understanding this correlation can facilitate timely diagnosis of acute appendicitis.

Methods: We retrospectively reviewed 12,545 cases of children aged 3-18 years who were admitted to the pediatric Emergency Department of University Medical Center between January 2015 and December 2020 with acute abdominal pain (≤ 7 days). A final diagnosis of acute appendicitis was determined in 1,401 patients (15.1%). Of these patients, 1,123 (80.1%) underwent appendectomy and 353 (25.0%) had complicated appendicitis.

Results: The results demonstrate significantly higher initial VAS scores in acute appendicitis patients compared to patients with abdominal pain from other etiologies. In addition, being young, male, and Jewish were all found to correlate with a reduced likelihood of acute appendicitis diagnosis in the study cohort. After adjusting for age, sex, and ethnicity, higher initial pain levels were positively correlated with the likelihood of an appendicitis diagnosis.

Conclusion: The degree of abdominal pain can serve as a valuable clinical marker for healthcare practitioners in assessing the likelihood of acute appendicitis. This tool can enhance the accuracy of current clinical scoring systems, thereby reducing the rate of appendicitis misdiagnosis and complications.