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Pediatric Appendicitis Score and Ultrasound in children with Acute Appendicitis: An Observational Study

Suyog Simkhada1, Bijay Thapa1, Anupama Thapa Basnet1

  • 1Department of Pediatrics Surgery, Kanti Children Hospital, Maharajgunj, Kathmandu, Nepal.

JNMA; Journal of the Nepal Medical Association
|July 14, 2025
PubMed

Insights

The Pediatric Appendicitis Score and ultrasound imaging are effective tools for diagnosing acute appendicitis in children, aiding in surgical decision-making for this common emergency.

Area of Science:

  • Pediatric Surgery
  • Diagnostic Imaging
  • Emergency Medicine

Background:

  • Acute appendicitis is a frequent surgical emergency in children.
  • Differentiating appendicitis from other conditions with similar symptoms is challenging in pediatric patients.
  • Clinical scoring systems and ultrasound are valuable for diagnosis and excluding differentials.

Purpose of the Study:

  • To evaluate the effectiveness of the Pediatric Appendicitis Score (PAS) and ultrasound in diagnosing acute appendicitis in children.
  • To assess the correlation between PAS, ultrasound findings, and confirmed appendicitis.

Main Methods:

  • An observational cross-sectional study was conducted with 50 children aged 5-14 years.
  • Provisional diagnosis was based on the Pediatric Appendicitis Score and ultrasound.
  • Histopathology confirmed the final diagnosis.

Main Results:

  • High-risk PAS ( >7) was noted in 86% of patients; intermediate-risk (4-6) in 12%.
  • Ultrasound showed an appendix diameter >6 mm in 78% of patients and <6 mm in 20%.

Conclusions:

  • The Pediatric Appendicitis Score is a reliable tool for assessing appendicitis risk in children.
  • Ultrasonography is effective in visualizing appendiceal abnormalities.
  • Both PAS and ultrasonography aid in the diagnosis of acute appendicitis in pediatric patients.
Abstract

Keywords:
acute appendicitiscomputed tomography scanhistopathological examinationpediatric appendicitis scoreultrasonography

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