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Diagnostic criteria of acute appendicitis in children

المعايير التشخيصية لالتهاب الزائدة الحاد عند الأطفال

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 Publication date 2018
  fields Medicine
and research's language is العربية
 Created by Shamra Editor




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The objective of this research is to insist on the most important symptoms and signs of appendicitis and diagnosis in a timely manner to avoid complications and deaths. The aim of the study was to establish diagnostic criteria for acute appendicitis in children in the light of the data obtained from the study of a large number of patients with appendicitis and to determine the surgical indication to reduce complications and negative abdominal opening and to include the studied criteria in a spec ial scale in our patients to evaluate children with acute appendicitis depending On this scale. The study included 104 children who visited the Pediatric emergency department at Al-Assad University and University Hospital and Tishreen university Hospital with a complaint of abdominal pain between 2014 and 2016. The number of male patients was 76 patients and 28 females, abdominal pain was present in all patients, The following criteria were studied (abdominal pain, abdominal tenderness, rebound tenderness, ultra sound, leukocytosis, shift to left, fever,crp). These criteria were studied to diagnose acute appendicitis and to put them in a special scale for use in diagnosis or denial acute appendicitis. In comparison with international standards, we observed that the scale studied in our study is more objective and eliminates the subjective factor in the diagnosis of appendicitis.


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Research summary
تأتي أهمية هذا البحث من التأكيد على الأعراض والعلامات الرئيسية لالتهاب الزائدة الحاد عند الأطفال والتشخيص في الوقت المناسب لتجنب المضاعفات والوفيات. الهدف من الدراسة هو وضع معايير تشخيصية لالتهاب الزائدة الحاد عند الأطفال بناءً على البيانات التي تم الحصول عليها من دراسة عدد كبير من المرضى الذين يعانون من التهاب الزائدة وتحديد الاستطباب الجراحي لتقليل المضاعفات وحالات فتح البطن السلبي. شملت الدراسة 1044 طفلاً من المراجعين لقسم إسعاف الأطفال في مشفيي الأسد الجامعي وتشرين الجامعي بين عامي 2014 و2016، وكانت أعمارهم دون 12 سنة. تضمنت المعايير المدروسة الألم البطني، الإيلام البطني، الإيلام المرتد، الإيكو، البروتين الارتكاسي، الكريات البيض، انحراف الصيغة للأيسر، والحرارة. تم وضع هذه المعايير في ميزان خاص يصلح للاستخدام في تشخيص أو نفي التهاب الزائدة الحاد. وأظهرت النتائج أن الميزان المدروس في هذه الدراسة أكثر موضوعية ويلغي العامل الشخصي في تشخيص التهاب الزائدة مقارنة بالمعايير العالمية. خلصت الدراسة إلى أن استخدام نظام عدد النقاط بناءً على المتغيرات المشمولة في الدراسة يمكن أن يكون فعالاً في تقييم الأطفال دون 12 سنة وتوجيه التدبير الطبي المناسب بناءً على مجموع النقاط المحقق.
Critical review
دراسة نقدية: تعتبر هذه الدراسة خطوة مهمة نحو تحسين تشخيص التهاب الزائدة الحاد عند الأطفال، إلا أن هناك بعض النقاط التي يمكن مناقشتها. أولاً، على الرغم من أن الدراسة شملت عددًا كبيرًا من الأطفال، إلا أن التركيز كان على مشفيين فقط، مما قد يحد من تعميم النتائج على نطاق أوسع. ثانياً، الاعتماد على الإيكو كمعيار ذهبي قد يكون محدودًا في الأماكن التي تفتقر إلى الأجهزة المتقدمة أو الأيدي الخبيرة. ثالثاً، لم يتم التطرق بشكل كافٍ إلى الفروق بين الجنسين في الاستجابة للعلاج والتشخيص، وهو ما يمكن أن يكون له تأثير على النتائج. وأخيراً، كان من الأفضل تضمين مقارنة أكثر تفصيلية مع معايير تشخيصية أخرى معتمدة عالميًا لتوضيح الفروق بشكل أوضح.
Questions related to the research
  1. ما هي الأهداف الرئيسية لهذه الدراسة؟

    الهدف الرئيسي من الدراسة هو وضع معايير تشخيصية لالتهاب الزائدة الحاد عند الأطفال لتجنب المضاعفات والوفيات وتحديد الاستطباب الجراحي المناسب.

  2. ما هي المعايير التي تم دراستها لتشخيص التهاب الزائدة الحاد؟

    المعايير التي تم دراستها تشمل الألم البطني، الإيلام البطني، الإيلام المرتد، الإيكو، البروتين الارتكاسي، الكريات البيض، انحراف الصيغة للأيسر، والحرارة.

  3. كم عدد الأطفال الذين شملتهم الدراسة؟

    شملت الدراسة 1044 طفلاً من المراجعين لقسم إسعاف الأطفال في مشفيي الأسد الجامعي وتشرين الجامعي.

  4. ما هي الاستنتاجات الرئيسية التي توصلت إليها الدراسة؟

    توصلت الدراسة إلى أن استخدام نظام عدد النقاط بناءً على المتغيرات المشمولة يمكن أن يكون فعالاً في تقييم الأطفال دون 12 سنة وتوجيه التدبير الطبي المناسب بناءً على مجموع النقاط المحقق.


References used
PURI P, MARTELL A , APPENDICITIS. IN: STRINGER MD, OLDHAM KT, Mouriquand PDE (eds) Pediatric Surgery and Urology: Long Term Outcomes, 2nd Edn. Cambridge University Press, Cambridge, 2006, 374–384
ASHCRAFT, K.W; HOLCOMB, G.W. Ashcraft’s pediatric surgery.5th.ed, Saunders Inc, United States of America, 2010.549
SALÖ M, OHLSSON B, ARNBJÖRNSSON E, STENSTRÖM P: Appendicitis in children from a gender perspective. Pediatr Surg Int. 31(9): 2015 Sep;845-53
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