[Prospective evaluation of admission for acute abdominal pain in children]

Acute abdominal pain (AAP) is one of the most frequent causes of admission to an emergency department of a childrens' hospital. The diagnosis viewed with the most apprehension is acute appendicitis. We present the results of a prospective study on the evaluation of the clinical and paraclinical symptoms generally observed in an AAP, and discuss the benefit of a diagnostic score for acute appendicitis. Twenty-five different diagnoses were observed, the 5 most frequent being: "non specific" (34.2%), constipation (16%), otorhinolaryngological infection (11.6%), gastroenteritis (10.7%) and acute appendicitis (10.5%). The study of 12 symptoms showed an elevated sensitivity for each one (92-50%), but a low positive predictive value (72-12%). Rigid adhesion to a diagnostic score would have led to unnecessary medical examination.