Researchers have identified a chemical in urine that is closely associated with appendicitis in children and are working to develop a simple test that could be used to diagnose the condition -- a test that would both increase the likelihood of performing surgery before the appendix bursts and prevent unnecessary surgery.
Preliminary results show that the test is highly accurate, producing very few instances in which cases are missed (false negatives) or children are incorrectly diagnosed with the condition (false positives), a team from Children's Hospital Boston reported today in the Annals of Emergency Medicine.
Appendicitis is the most common childhood surgical emergency. The lifetime prevalence of appendicitis is 9% for males and 7% for females, but the bulk of the cases occur in childhood or adolescence. In the past, diagnosis was made simply from clinical symptoms, such as abdominal pain, and as many as 30% of cases in which surgery was performed revealed a healthy appendix.
Within the last few years, emergency room specialists have begun using CT scans for diagnosis, which reduces the number of unnecessary surgeries to as low as 5%. But in as many as 30% to 45% of those diagnosed with appendicitis, the organ has already ruptured at the time of surgery, leading to a variety of complications that lengthen hospital stays.