Application of the MANTRELS scoring system in the diagnosis of acute appendicitis in children.

Abstract

Evaluation of abdominal pain in children poses a major challenge for the pediatrician and pediatric surgeon alike. Acute appendicitis is diagnosed in 1%-8% of children who present with acute abdominal pain in pediatric department. However, initial misdiagnosis rate in childhood is still high, so how to make early and adequate diagnosis of acute appendicitis is still a challenge to pediatrician. Application of the MANTRELS scoring system (Alvarado score) was used in the diagnosis of acute appendicitis in children. We retrospectively collected a total of 111 cases under 14 years who were proven to have acute appendicitis by operative and pathologic reports and 111 cases who were excluded from having acute appendicitis as control subjects from January 2001 to July 2003. We applied the MANTRELS scores to evaluate these patients. Using statistical analysis, the following four parameters: migration pain, rebounding tenderness, right lower quadrant tenderness, shift WBC count and total MANTRELS scores higher than 6 were shown to have discriminatory values (P<0.01). Assessment of the cases in children with suspected acute appendicitis by the MANTRELS scoring system can be an adjuvant method to help us in the early diagnosis of acute appendicitis.