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Diagnosis of acute appendicitis in children using urinary 5-hydroxy indol acetic acid and pediatric appendicitis

Mohammad Gharieb Khirallah1, Muhammad Tarek Abdel Ghafar2

  • 1Departments of Pediatric Surgery, Tanta University, Egypt.

Annals of Medicine and Surgery (2012)
|April 26, 2021
PubMed

Insights

Diagnosing acute appendicitis in children is challenging. A new model combining urinary 5-hydroxyindoleacetic acid (5-HIAA) and the pediatric appendicitis score improves diagnostic accuracy and reduces negative appendectomies.

Area of Science:

  • Pediatric Surgery
  • Diagnostic Medicine
  • Biochemical Markers

Background:

  • Acute appendicitis is a frequent pediatric surgical emergency.
  • Accurate diagnosis in children can be hindered by nonspecific symptoms.
  • Existing diagnostic tools include scoring systems and laboratory tests.

Purpose of the Study:

  • To develop a diagnostic model for acute appendicitis in children.
  • To evaluate the utility of urinary 5-hydroxyindoleacetic acid (5-HIAA) in conjunction with the pediatric appendicitis score.

Main Methods:

  • A study involving 191 children with suspected acute appendicitis.
  • Group A: Evaluated using pediatric appendicitis score, ultrasound, and C-reactive protein (CRP).
  • Group B: Evaluated as in Group A, with the addition of urinary 5-HIAA measurement.

Main Results:

  • Mean age of participants was 13.3 years.
  • Mean urinary 5-HIAA level in appendicitis patients in Group B was 43.53 ± 24.05.
  • Group B showed a reduction in negative appendectomies (7 vs. 13) and readmissions (7 vs. 13) compared to Group A.

Conclusions:

  • The combined use of urinary 5-HIAA and the pediatric appendicitis score creates an effective diagnostic model.
  • This integrated approach enhances diagnostic accuracy for acute appendicitis in children.
  • The model successfully reduces negative appendectomies and minimizes missed diagnoses or readmissions.
Abstract

Keywords:
5-HIAAAppendicitisChildrenDiagnosisScoring systems

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