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2017, Number 1

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Rev Mex Pediatr 2017; 84 (1)

Thermic difference between iliac fossae: diagnosis and prediction of acute appendicitis

Avilés-Martínez KI, González-Cortés LF, Aguirre-Jáuregui Ó

Language: Spanish
References: 15
Page: 5-9
PDF size: 251.09 Kb.


ABSTRACT

The diagnostic suspicion of acute appendicitis is clinical. The acute process starts in the right iliac fossae and it seems possible that signs of acute inflammation such as local heat and pain may provide additional clinical information complimentary in the diagnostic decision.Objective: To determine the accuracy of the increase in temperature in the right iliac fossa for the diagnosis of acute appendicitis in children. Material and methods: Diagnostic test study. We included 214 children with abdominal pain and suspected acute appendicitis in whom the comparison between the two iliac fossae temperature, that was assessed with an infrared thermometer. Diagnostic test was considered positive when the temperature in the right iliac fossa (RIF) was › 0.5 oC than the obtained in the left iliaca fossa. Results: In 161 children appendicitis was confirmed; 61 had temperature increased › 0.5 oC in RIF. Sensitivity was 38% (95% CI 1.2-5.6), specificity 81% (95% CI 71-92), pretest odds 50% and post test odds 67%. Conclusions: The comparative temperature measurement in both iliac fossae is a useful tool as diagnostic test of acute appendicitis, particularly for its specificity.


REFERENCES

  1. Humes DJ, Simpson J. Acute appendicitis. BMJ. 2006; 333(7567): 530-534.

  2. Bundy DG, Byerley JS, Liles EA, Perrin EM, Katznelson J, Rice HE. Does this child have appendicitis? JAMA. 2007; 298(4): 438-451.

  3. Flores-Nava G, Jamaica-Balderas M, Landa-García RA, Parraguirre-Martínez S, Lavalle-Villalobos A. Apendicitis en la etapa pediátrica: correlación clínica-patológica. Bol Med Hosp Infant Mex. 2005; 62(3): 195-201.

  4. Ohle R, O’Reilly F, O’Brien KK, Fahey T, Dimitrov BD. The Alvarado score for predicting acute appendicitis: a systematic review. BMC Med. 2011; 9: 139.

  5. Howell JM, Eddy OL, Lukens TW, Thiessen ME, Weingart SD, Decker WW; American College of Emergency Physicians. Clinical policy: critical issues in the evaluation and management of emergency department patients with suspected appendicitis. Ann Emerg Med. 2010; 55(1): 71-116.

  6. Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ et al. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis. 2010; 50(2): 133-164.

  7. Davies P, Bailey PJ, Goldenberg MM, Ford-Hutchinson AW. The role of arachidonic acid oxygenation products in pain and inflammation. Annu Rev Immunol. 1984; 2: 335-357.

  8. Young P. Appendicitis and its history. Rev Med Chil. 2014; 142(5): 667-672.

  9. Marzuillo P, Germani C, Krauss BS, Barbi E. Appendicitis in children less than five years old: a challenge for the general practitioner. World J Clin Pediatr. 2015; 4(2): 19-24.

  10. Secretaria de Salud México. Diagnóstico de apendicitis aguda. Guía de práctica clínica. Catálogo Maestro de Guías de Práctica Clínica: IMSS-031-08. México: Gobierno Federal de México, Secretaria de Salud, SEDENA, SEMANAR, IMSS, Centro Nacional de Excelencia Tecnológica en Salud; 2009.

  11. Burjonrappa S, Rachel D. Pediatric appendectomy: optimal surgical timing and risk assessment. Am Surg. 2014; 80(5): 496-499.

  12. Becker T, Kharbanda A, Bachur R. Atypical clinical features of pediatric appendicitis. Acad Emerg Med. 2007; 14(2): 124-129.

  13. Obermaier R, Benz S, Asgharnia M, Kirchner R, Hopt UT. Value of ultrasound in the diagnosis of acute appendicitis: interesting aspects. Eur J Med Res. 2003; 8(10): 451-456.

  14. Kumar V; Abbas AK, Fausto N, Aster J. Ch. 2: Acute and chronic inflammation. In: Robbins & Cotran pathologic basis of disease. 8th ed. Philadelphia: Saunders (Elsevier); 2009. ISBN 978-1-4160-3121-5.

  15. Galai T, Beloosesky OZ, Scolnik D, Rimon A, Glatstein M. Misdiagnosis of acute appendicitis in children attending the emergency department: the experience of a large, Tertiary Care Pediatric Hospital. Eur J Pediatr Surg. 2016 Jan 8. [Epub ahead of print] doi: 10.1055/s-0035-1570757.




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