Abdominal pain: when should we consider acute appendicitis? : epidemiological and clinical characteristics of children admitted to the Uruguayan Police Forces hospital between june 2008 and november 2014

Dolor abdominal: ¿cuándo pensar en apendicitis aguda? Características epidemiológicas y clínicas de niños ingresados en el Hospital Policial (junio 2008 - noviembre 2014)

Dor abdominal: quando pensar em apendicite aguda? : características epidemiológicas e clínicas de crianças admitidas no hospital policial de Uruguay em junho de 2008 a novembro de 2014

Gómez, Noelia - Pujadas, Mónica - Parodi, Verónica - Kenny, Juan - Iglesias, Daniel - Martínez, Osvaldo

Resumen:

Introduction: acute abdominal pain is a reason for frequent consultation in Pediatrics. It is important to diagnose acute appendicitis in time, thus reducing morbidity and mortality. Objective: to analyze the epidemiological characteristics, statistics and evolution of children admitted for abdominal pain. Identify the clinical and paraclinical characteristics that lead to diagnosis of acute appendicitis. Methodology: observational, descriptive, retrospective study of children under 14 years of age previously admitted to the Pediatric ward from June 2008 to November 2014. Data source: Review of Electronic Medical Records. Results: we included 217 patients, 52% girls (112) and 48% boys (105). The pain was in the right iliac fossa 51% (110). 29% (63) of the cases took place in Spring, 24% (52) Summer, 24% (52) Autumn and 23% (50) in Winter. Of the children with appendicitis: 61% (54) presented vomiting, 26% (23) saburral tongue, 40% (39) fever, and 53% of them (19) had 38 to 38.9°C temperature. 45% (40) of them showed more than 15,000 leukocytes, 41% (37) less than 15,000 and no blood count was performed on 14% of patients. CRP was lower than 20 mg/L in 32% (28) of patients and higher in 22% (20) of them. Abdominal ultrasound was normal in 56% (22) of patients. 5% (6) of them presented complications during hospitalization. Conclusions: the most frequent diagnosis was acute appendicitis, followed by nonspecific abdominal pain. Most appendicitis cases diagnosed were confirmed intraoperatively and through pathological anatomical analysis. Pain as a symptom had a better diagnostic performance. Vomiting and fever are associated with a higher probability of acute appendicitis. 40% of the patients had fever, mainly between 38 and 38.9°C. Leukocytosis and C-reactive protein were leading factors for the diagnosis of appendicitis. Abdominal ultrasound was also inconclusive.

Introducción: el dolor abdominal agudo es un motivo de consulta frecuente en pediatría. Es importante realizar oportunamente el diagnóstico de apendicitis aguda, ya que esto contribuye a disminuir la morbimortalidad.  Objetivo: analizar las características epidemiológicas, clínicas y evolución de niños ingresados por dolor abdominal. Identificar características clínicas y paraclínicas que orienten al diagnóstico oportuno de apendicitis aguda.  Metodología: estudio observacional, descriptivo, retrospectivo, incluyendo niños menores de 14 años ingresados en sala de Pediatría entre junio de 2008 y noviembre de 2014. Fuente de datos: revisión de historias clínicas.

Introdução: a dor abdominal aguda é motivo frequente de consulta pediátrica. É importante fazer um diagnóstico oportuno da apendicite aguda, pois isso contribui para diminuir a sua morbimortalidade. Objetivo: analisar características epidemiológicas, clínicas e evolução de crianças internadas por dor abdominal. Identificar as características clínicas e paraclínicas que levam ao diagnóstico oportuno de apendicite aguda. Metodologia: estudo observacional, descritivo, retrospectivo, realizado a crianças menores de 14 anos de idade internadas na Enfermaria Pediátrica de junho de 2008 a novembro de 2014. Fonte de dados: revisão dos Prontuários Médicos. Resultados: foram incluídos 217 pacientes, 52% meninas (112) e 48% meninos (105). A dor localizou-se na fossa ilíaca direita 51% (110). 29% (63) dos casos ocorreram na primavera, 24% (52) no verão, 24% (52) no outono e 23% (50) no inverno. Das crianças com apendicite: 61% (54) apresentaram vômitos, 26% (23) língua saburral, 40% (39) febre e 53% delas (19) apresentaram temperatura de 38 a 38,9°C. 45% (40) delas apresentaram mais de 15.000 leucócitos, 41% (37) menos de 15.000 e não realizamos nenhum hemograma em 14% dos pacientes. A PCR foi inferior a 20 mg/L em 32% (28) dos pacientes e superior em 22% (20) deles. A ultrassonografia abdominal foi normal em 56% (22) dos pacientes. 5% (6) deles apresentaram complicações durante a internação. Conclusões: o diagnóstico mais frequente foi apendicite aguda, seguida de dor abdominal inespecífica. A maioria dos casos de apendicite diagnosticada foi confirmada no intra-operatório e através da análise anatômica patológica. A dor como sintoma apresentou melhor desempenho diagnóstico. Vômitos e febre estiveram associados a uma maior probabilidade de apendicite aguda. 40% dos pacientes apresentaram febre, principalmente entre 38 e 38,9°C. A Leucocitose e a Proteína C-reativa foram os principais fatores para realizar o diagnóstico de apendicite. O ultrassom abdominal também foi inconclusivo.

Detalles Bibliográficos
2020
Apendicitis
Dolor abdominal
Appendicitis
Abdominal pain
Apendicite
Dor abdominal
Español
Sociedad Uruguaya de Pediatría
Archivos de Pediatría del Uruguay
https://adp.sup.org.uy/index.php/adp/article/view/80
https://doi.org/10.31134/AP.91.2.2
Acceso abierto
CreativeCommons by/4.0
_version_ 1872149965770326016
author Gómez, Noelia
author2 Pujadas, Mónica
Parodi, Verónica
Kenny, Juan
Iglesias, Daniel
Martínez, Osvaldo
author2_role author
author
author
author
author
author_facet Gómez, Noelia
Pujadas, Mónica
Parodi, Verónica
Kenny, Juan
Iglesias, Daniel
Martínez, Osvaldo
author_role author
collection Archivos de Pediatría del Uruguay
dc.creator.none.fl_str_mv Gómez, Noelia
Pujadas, Mónica
Parodi, Verónica
Kenny, Juan
Iglesias, Daniel
Martínez, Osvaldo
dc.date.none.fl_str_mv 2020-04-01
dc.description.abstract.none.fl_txt_mv Introduction: acute abdominal pain is a reason for frequent consultation in Pediatrics. It is important to diagnose acute appendicitis in time, thus reducing morbidity and mortality. Objective: to analyze the epidemiological characteristics, statistics and evolution of children admitted for abdominal pain. Identify the clinical and paraclinical characteristics that lead to diagnosis of acute appendicitis. Methodology: observational, descriptive, retrospective study of children under 14 years of age previously admitted to the Pediatric ward from June 2008 to November 2014. Data source: Review of Electronic Medical Records. Results: we included 217 patients, 52% girls (112) and 48% boys (105). The pain was in the right iliac fossa 51% (110). 29% (63) of the cases took place in Spring, 24% (52) Summer, 24% (52) Autumn and 23% (50) in Winter. Of the children with appendicitis: 61% (54) presented vomiting, 26% (23) saburral tongue, 40% (39) fever, and 53% of them (19) had 38 to 38.9°C temperature. 45% (40) of them showed more than 15,000 leukocytes, 41% (37) less than 15,000 and no blood count was performed on 14% of patients. CRP was lower than 20 mg/L in 32% (28) of patients and higher in 22% (20) of them. Abdominal ultrasound was normal in 56% (22) of patients. 5% (6) of them presented complications during hospitalization. Conclusions: the most frequent diagnosis was acute appendicitis, followed by nonspecific abdominal pain. Most appendicitis cases diagnosed were confirmed intraoperatively and through pathological anatomical analysis. Pain as a symptom had a better diagnostic performance. Vomiting and fever are associated with a higher probability of acute appendicitis. 40% of the patients had fever, mainly between 38 and 38.9°C. Leukocytosis and C-reactive protein were leading factors for the diagnosis of appendicitis. Abdominal ultrasound was also inconclusive.
Introducción: el dolor abdominal agudo es un motivo de consulta frecuente en pediatría. Es importante realizar oportunamente el diagnóstico de apendicitis aguda, ya que esto contribuye a disminuir la morbimortalidad.  Objetivo: analizar las características epidemiológicas, clínicas y evolución de niños ingresados por dolor abdominal. Identificar características clínicas y paraclínicas que orienten al diagnóstico oportuno de apendicitis aguda.  Metodología: estudio observacional, descriptivo, retrospectivo, incluyendo niños menores de 14 años ingresados en sala de Pediatría entre junio de 2008 y noviembre de 2014. Fuente de datos: revisión de historias clínicas.
Introdução: a dor abdominal aguda é motivo frequente de consulta pediátrica. É importante fazer um diagnóstico oportuno da apendicite aguda, pois isso contribui para diminuir a sua morbimortalidade. Objetivo: analisar características epidemiológicas, clínicas e evolução de crianças internadas por dor abdominal. Identificar as características clínicas e paraclínicas que levam ao diagnóstico oportuno de apendicite aguda. Metodologia: estudo observacional, descritivo, retrospectivo, realizado a crianças menores de 14 anos de idade internadas na Enfermaria Pediátrica de junho de 2008 a novembro de 2014. Fonte de dados: revisão dos Prontuários Médicos. Resultados: foram incluídos 217 pacientes, 52% meninas (112) e 48% meninos (105). A dor localizou-se na fossa ilíaca direita 51% (110). 29% (63) dos casos ocorreram na primavera, 24% (52) no verão, 24% (52) no outono e 23% (50) no inverno. Das crianças com apendicite: 61% (54) apresentaram vômitos, 26% (23) língua saburral, 40% (39) febre e 53% delas (19) apresentaram temperatura de 38 a 38,9°C. 45% (40) delas apresentaram mais de 15.000 leucócitos, 41% (37) menos de 15.000 e não realizamos nenhum hemograma em 14% dos pacientes. A PCR foi inferior a 20 mg/L em 32% (28) dos pacientes e superior em 22% (20) deles. A ultrassonografia abdominal foi normal em 56% (22) dos pacientes. 5% (6) deles apresentaram complicações durante a internação. Conclusões: o diagnóstico mais frequente foi apendicite aguda, seguida de dor abdominal inespecífica. A maioria dos casos de apendicite diagnosticada foi confirmada no intra-operatório e através da análise anatômica patológica. A dor como sintoma apresentou melhor desempenho diagnóstico. Vômitos e febre estiveram associados a uma maior probabilidade de apendicite aguda. 40% dos pacientes apresentaram febre, principalmente entre 38 e 38,9°C. A Leucocitose e a Proteína C-reativa foram os principais fatores para realizar o diagnóstico de apendicite. O ultrassom abdominal também foi inconclusivo.
dc.format.none.fl_str_mv application/pdf
dc.identifier.doi.none.fl_str_mv https://doi.org/10.31134/AP.91.2.2
dc.identifier.none.fl_str_mv https://adp.sup.org.uy/index.php/adp/article/view/80
dc.language.iso.none.fl_str_mv spa
dc.publisher.none.fl_str_mv Sociedad Uruguaya de Pediatría
dc.relation.none.fl_str_mv https://adp.sup.org.uy/index.php/adp/article/view/80/67
dc.rights.license.none.fl_str_mv CreativeCommons by/4.0
dc.rights.none.fl_str_mv https://creativecommons.org/licenses/by/4.0
info:eu-repo/semantics/openAccess
dc.source.none.fl_str_mv Archives of Pediatrics of Uruguay; Vol. 91 No. 2 (2020): Abril; 78-83
Archivos de Pediatría del Uruguay; Vol. 91 Núm. 2 (2020): Abril; 78-83
Archivos de Pediatría del Uruguay; v. 91 n. 2 (2020): Abril; 78-83
1688-1249
0004-0584
reponame:Archivos de Pediatría del Uruguay
instname:Sociedad Uruguaya de Pediatría
instacron:Sociedad Uruguaya de Pediatría
dc.subject.none.fl_str_mv Apendicitis
Dolor abdominal
Appendicitis
Abdominal pain
Apendicite
Dor abdominal
dc.title.none.fl_str_mv Abdominal pain: when should we consider acute appendicitis? : epidemiological and clinical characteristics of children admitted to the Uruguayan Police Forces hospital between june 2008 and november 2014
Dolor abdominal: ¿cuándo pensar en apendicitis aguda? Características epidemiológicas y clínicas de niños ingresados en el Hospital Policial (junio 2008 - noviembre 2014)
Dor abdominal: quando pensar em apendicite aguda? : características epidemiológicas e clínicas de crianças admitidas no hospital policial de Uruguay em junho de 2008 a novembro de 2014
dc.type.none.fl_str_mv info:eu-repo/semantics/article
dc.type.version.none.fl_str_mv info:eu-repo/semantics/publishedVersion
description Introduction: acute abdominal pain is a reason for frequent consultation in Pediatrics. It is important to diagnose acute appendicitis in time, thus reducing morbidity and mortality. Objective: to analyze the epidemiological characteristics, statistics and evolution of children admitted for abdominal pain. Identify the clinical and paraclinical characteristics that lead to diagnosis of acute appendicitis. Methodology: observational, descriptive, retrospective study of children under 14 years of age previously admitted to the Pediatric ward from June 2008 to November 2014. Data source: Review of Electronic Medical Records. Results: we included 217 patients, 52% girls (112) and 48% boys (105). The pain was in the right iliac fossa 51% (110). 29% (63) of the cases took place in Spring, 24% (52) Summer, 24% (52) Autumn and 23% (50) in Winter. Of the children with appendicitis: 61% (54) presented vomiting, 26% (23) saburral tongue, 40% (39) fever, and 53% of them (19) had 38 to 38.9°C temperature. 45% (40) of them showed more than 15,000 leukocytes, 41% (37) less than 15,000 and no blood count was performed on 14% of patients. CRP was lower than 20 mg/L in 32% (28) of patients and higher in 22% (20) of them. Abdominal ultrasound was normal in 56% (22) of patients. 5% (6) of them presented complications during hospitalization. Conclusions: the most frequent diagnosis was acute appendicitis, followed by nonspecific abdominal pain. Most appendicitis cases diagnosed were confirmed intraoperatively and through pathological anatomical analysis. Pain as a symptom had a better diagnostic performance. Vomiting and fever are associated with a higher probability of acute appendicitis. 40% of the patients had fever, mainly between 38 and 38.9°C. Leukocytosis and C-reactive protein were leading factors for the diagnosis of appendicitis. Abdominal ultrasound was also inconclusive.
eu_rights_str_mv openAccess
format article
id SUP-OJS_008b85be5288b67847f5f4ad32186b3d
instacron_str Sociedad Uruguaya de Pediatría
institution Sociedad Uruguaya de Pediatría
instname_str Sociedad Uruguaya de Pediatría
language spa
network_acronym_str SUP-OJS
network_name_str Archivos de Pediatría del Uruguay
oai_identifier_str oai:ojs.sup.org.uy:article/80
publishDate 2020
publisher.none.fl_str_mv Sociedad Uruguaya de Pediatría
reponame_str Archivos de Pediatría del Uruguay
repository.mail.fl_str_mv
repository.name.fl_str_mv Archivos de Pediatría del Uruguay - Sociedad Uruguaya de Pediatría
repository_id_str
rights_invalid_str_mv https://creativecommons.org/licenses/by/4.0
CreativeCommons by/4.0
spelling Abdominal pain: when should we consider acute appendicitis? : epidemiological and clinical characteristics of children admitted to the Uruguayan Police Forces hospital between june 2008 and november 2014Dolor abdominal: ¿cuándo pensar en apendicitis aguda? Características epidemiológicas y clínicas de niños ingresados en el Hospital Policial (junio 2008 - noviembre 2014)Dor abdominal: quando pensar em apendicite aguda? : características epidemiológicas e clínicas de crianças admitidas no hospital policial de Uruguay em junho de 2008 a novembro de 2014Gómez, NoeliaPujadas, MónicaParodi, VerónicaKenny, JuanIglesias, DanielMartínez, OsvaldoApendicitisDolor abdominalAppendicitisAbdominal painApendiciteDor abdominalIntroduction: acute abdominal pain is a reason for frequent consultation in Pediatrics. It is important to diagnose acute appendicitis in time, thus reducing morbidity and mortality. Objective: to analyze the epidemiological characteristics, statistics and evolution of children admitted for abdominal pain. Identify the clinical and paraclinical characteristics that lead to diagnosis of acute appendicitis. Methodology: observational, descriptive, retrospective study of children under 14 years of age previously admitted to the Pediatric ward from June 2008 to November 2014. Data source: Review of Electronic Medical Records. Results: we included 217 patients, 52% girls (112) and 48% boys (105). The pain was in the right iliac fossa 51% (110). 29% (63) of the cases took place in Spring, 24% (52) Summer, 24% (52) Autumn and 23% (50) in Winter. Of the children with appendicitis: 61% (54) presented vomiting, 26% (23) saburral tongue, 40% (39) fever, and 53% of them (19) had 38 to 38.9°C temperature. 45% (40) of them showed more than 15,000 leukocytes, 41% (37) less than 15,000 and no blood count was performed on 14% of patients. CRP was lower than 20 mg/L in 32% (28) of patients and higher in 22% (20) of them. Abdominal ultrasound was normal in 56% (22) of patients. 5% (6) of them presented complications during hospitalization. Conclusions: the most frequent diagnosis was acute appendicitis, followed by nonspecific abdominal pain. Most appendicitis cases diagnosed were confirmed intraoperatively and through pathological anatomical analysis. Pain as a symptom had a better diagnostic performance. Vomiting and fever are associated with a higher probability of acute appendicitis. 40% of the patients had fever, mainly between 38 and 38.9°C. Leukocytosis and C-reactive protein were leading factors for the diagnosis of appendicitis. Abdominal ultrasound was also inconclusive. Introducción: el dolor abdominal agudo es un motivo de consulta frecuente en pediatría. Es importante realizar oportunamente el diagnóstico de apendicitis aguda, ya que esto contribuye a disminuir la morbimortalidad.  Objetivo: analizar las características epidemiológicas, clínicas y evolución de niños ingresados por dolor abdominal. Identificar características clínicas y paraclínicas que orienten al diagnóstico oportuno de apendicitis aguda.  Metodología: estudio observacional, descriptivo, retrospectivo, incluyendo niños menores de 14 años ingresados en sala de Pediatría entre junio de 2008 y noviembre de 2014. Fuente de datos: revisión de historias clínicas. Introdução: a dor abdominal aguda é motivo frequente de consulta pediátrica. É importante fazer um diagnóstico oportuno da apendicite aguda, pois isso contribui para diminuir a sua morbimortalidade. Objetivo: analisar características epidemiológicas, clínicas e evolução de crianças internadas por dor abdominal. Identificar as características clínicas e paraclínicas que levam ao diagnóstico oportuno de apendicite aguda. Metodologia: estudo observacional, descritivo, retrospectivo, realizado a crianças menores de 14 anos de idade internadas na Enfermaria Pediátrica de junho de 2008 a novembro de 2014. Fonte de dados: revisão dos Prontuários Médicos. Resultados: foram incluídos 217 pacientes, 52% meninas (112) e 48% meninos (105). A dor localizou-se na fossa ilíaca direita 51% (110). 29% (63) dos casos ocorreram na primavera, 24% (52) no verão, 24% (52) no outono e 23% (50) no inverno. Das crianças com apendicite: 61% (54) apresentaram vômitos, 26% (23) língua saburral, 40% (39) febre e 53% delas (19) apresentaram temperatura de 38 a 38,9°C. 45% (40) delas apresentaram mais de 15.000 leucócitos, 41% (37) menos de 15.000 e não realizamos nenhum hemograma em 14% dos pacientes. A PCR foi inferior a 20 mg/L em 32% (28) dos pacientes e superior em 22% (20) deles. A ultrassonografia abdominal foi normal em 56% (22) dos pacientes. 5% (6) deles apresentaram complicações durante a internação. Conclusões: o diagnóstico mais frequente foi apendicite aguda, seguida de dor abdominal inespecífica. A maioria dos casos de apendicite diagnosticada foi confirmada no intra-operatório e através da análise anatômica patológica. A dor como sintoma apresentou melhor desempenho diagnóstico. Vômitos e febre estiveram associados a uma maior probabilidade de apendicite aguda. 40% dos pacientes apresentaram febre, principalmente entre 38 e 38,9°C. A Leucocitose e a Proteína C-reativa foram os principais fatores para realizar o diagnóstico de apendicite. O ultrassom abdominal também foi inconclusivo.Sociedad Uruguaya de Pediatría2020-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://adp.sup.org.uy/index.php/adp/article/view/80https://doi.org/10.31134/AP.91.2.2Archives of Pediatrics of Uruguay; Vol. 91 No. 2 (2020): Abril; 78-83 Archivos de Pediatría del Uruguay; Vol. 91 Núm. 2 (2020): Abril; 78-83 Archivos de Pediatría del Uruguay; v. 91 n. 2 (2020): Abril; 78-83 1688-12490004-0584reponame:Archivos de Pediatría del Uruguayinstname:Sociedad Uruguaya de Pediatríainstacron:Sociedad Uruguaya de Pediatríaspahttps://adp.sup.org.uy/index.php/adp/article/view/80/67Derechos de autor 2020 Noelia Gómez, Mónica Pujadas, Verónica Parodi, Juan Kenny, Daniel Iglesias, Osvaldo Martínezhttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessCreativeCommons by/4.02026-07-14T17:47:44Zoai:ojs.sup.org.uy:article/80Portal de revistashttps://adp.sup.org.uy/index.php/adpOrganización no gubernamentalhttps://www.sup.org.uy/https://adp.sup.org.uy/index.php/adp/oaiUruguayopendoar:2026-07-14T17:47:44Archivos de Pediatría del Uruguay - Sociedad Uruguaya de Pediatríafalse
spellingShingle Abdominal pain: when should we consider acute appendicitis? : epidemiological and clinical characteristics of children admitted to the Uruguayan Police Forces hospital between june 2008 and november 2014
Gómez, Noelia
Apendicitis
Dolor abdominal
Appendicitis
Abdominal pain
Apendicite
Dor abdominal
status_str publishedVersion
title Abdominal pain: when should we consider acute appendicitis? : epidemiological and clinical characteristics of children admitted to the Uruguayan Police Forces hospital between june 2008 and november 2014
title_full Abdominal pain: when should we consider acute appendicitis? : epidemiological and clinical characteristics of children admitted to the Uruguayan Police Forces hospital between june 2008 and november 2014
title_fullStr Abdominal pain: when should we consider acute appendicitis? : epidemiological and clinical characteristics of children admitted to the Uruguayan Police Forces hospital between june 2008 and november 2014
title_full_unstemmed Abdominal pain: when should we consider acute appendicitis? : epidemiological and clinical characteristics of children admitted to the Uruguayan Police Forces hospital between june 2008 and november 2014
title_short Abdominal pain: when should we consider acute appendicitis? : epidemiological and clinical characteristics of children admitted to the Uruguayan Police Forces hospital between june 2008 and november 2014
title_sort Abdominal pain: when should we consider acute appendicitis? : epidemiological and clinical characteristics of children admitted to the Uruguayan Police Forces hospital between june 2008 and november 2014
topic Apendicitis
Dolor abdominal
Appendicitis
Abdominal pain
Apendicite
Dor abdominal
url https://adp.sup.org.uy/index.php/adp/article/view/80
https://doi.org/10.31134/AP.91.2.2