DIAGNOSTIC VALUE OF A NUMBER OF ANAMNESTIC, CLINICAL AND LABORATORY DATA USED IN THE DIFFERENTIAL DIAGNOSIS OF ACUTE ABDOMINAL PAIN IN CHILDREN
Abstract
Вackground. Acute abdominal pain is one of the most common symptoms in pediatric practice. The problems of rapid, accurate and timely differential diagnosis have not been solved to date. Objective. To determine the diagnostic value of a number of anamnestic, clinical and laboratory data used in differential diagnosis of acute abdominal pain in children. Material and methods. A prospective randomized blind controlled clinical study. 597 children aged from one year to 18 years with acute abdominal pain were examined according to the analytical chart developed in the clinic. Results. The use of such clinical signs as “nausea, vomiting, pain migration, local pain in the right iliac region” in the differential diagnosis of acute abdominal pain is of subsidiary importance. Diagnostically the most important and informative for stratification aimed to distinguish patients with possible destructive appendicitis are such symptoms as “anorexia, muscle tension, Shchetkin’s symptom, Razdolsky’s symptom”, the number of leukocytes, the number of polymorphonuclear neutrophils. It is advisable to use the absolute neutrophil count instead of the relative neutrophil count. None of the abovementioned symptoms has sufficient diagnostic value to establish the diagnosis of “destructive appendicitis”. Conclusion. Consistent evaluation of these symptoms may improve the quality of differential diagnosis of acute abdominal pain in children and to distinguish patients requiring surgical treatment.
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