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Year : 2015  |  Volume : 3  |  Issue : 2  |  Page : 29-32

Outcome analysis of acute abdominal pain and correlation of Alvarado score with diagnosis

Department of Paediatric Surgery, TNMC and BYL Nair Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Hemanshi Shah
Department of Paediatric Surgery, TNMC and BYL Nair Hospital, Mumbai - 400 008, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2320-3846.175213

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Background: Abdominal pain is a very common symptom in pediatric age group. Not all patients presenting with acute pain abdomen require surgical intervention. Hence, an accurate diagnosis based on appropriate investigations is absolutely necessary. Methods: One hundred admitted patients with acute abdominal pain were analyzed, and Alvarado score was calculated for each of them. Conservative or operative management was done depending on the diagnosis thus obtained from these investigations as per the set departmental protocols. Alvarado score was correlated with diagnosis in these children. Results: The mean age of presentation was 70.4 months; range of age being 4 months and 144 months. They were 69 males and 31 females. The most common presenting symptoms besides abdominal pain were vomiting (83), anorexia (73), and nausea (36). The most common diagnoses were intussusception (26), mesenteric lymphadenitis (21), acute appendicitis (13), and appendicular perforation (7). Operative intervention was required in 38 patients out of which 23 were emergency explorations. There were 78 patients in Alvarado score of 5–6; 15 patients in Alvarado score 7–8; and 7 patients in Alvarado score 9 or more. The diagnosis of patients with lower Alvarado Score was mostly intussusception and mesenteric lymphadenopathy whereas as the score increased, the diagnosis of acute appendicitis and appendicular perforation became more common. There was no mortality and all patients are doing well on follow-up. Conclusion: Though most of the patients of acute pain abdomen present with symptoms mimicking acute appendicitis, the most common definitive diagnosis in the pediatric age group with lower Alvarado score are intussusception and mesenteric lymphadenitis which can be managed conservatively most of the times.

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