Evaluating the utility of Paediatric appendicitis score (PAS) score in case of children suspected with acute appendicitis over a period of time, correlation with ultrasonography and intra-operative findings, and a single institutional study

Abstract

Introduction: Accurate and prompt diagnosis, appropriate surgical management and proper post-operative management are required in children to avoid complications. Despite intensive research and discussion, rapid, accurate diagnosis of pediatric appendicitis remains an elusive challenge. CT has better performance than US in diagnosing acute appendicitis, but the widespread use of CT is currently under scrutiny, given the increased awareness and concern about exposure to ionizing radiation in children. Paediatric appendicitis score (PAS) was developed by Samuel in 2002, has 100% sensitivity and 92% specificity. Materials and method: We undertook a study study to address the usefulness of more validated PAS, first time in Indian population, to assess role of emergency ultrasonography and its correlation with PAS and to assess impact of the PAS on patient outcomes. Results: Out of 145 patients, 111 underwent surgery (100 open appendectomies, 10 laparoscopic appendectomies). Of 111operated patients 75 (67.56%) were male and 36 (32.44%) were female. Mean (median, SD, range) duration of symptoms of appendicitis group was 2.56 (2, ±1.09, and 1-5) days. We used in PAS with cut off point 6 and showed sensitivity of 92.8% and specificity of 69.3%. Conclusion: Though this score was found to be useful in suspected cases of acute appendicitis and significant decrease was noticed in the negative and missed appendicectomy rates.