Clinical Scoring for Diagnosis of Acute Lower Abdominal Pain in Female of Reproductive Age

Kijja Jearwattanakanok,Sirikan Yamada,Watcharin Suntornlimsiri,Waratsuda Smuthtai,Jayanton Patumanond

doi:10.1155/2013/730167

Kijja Jearwattanakanok, Sirikan Yamada + Show 3 more

Open Access

https://doi.org/10.1155/2013/730167

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Abstract

Background. Obstetrics and gynecological conditions (OB-GYNc) are difficult to be differentiated from appendicitis in young adult females presenting with acute lower abdominal pain. Timely and correct diagnosis is clinically challenging. Method. A retrospective data analysis was performed on 542 female patients who were admitted to a tertiary care hospital with a chief complaint of acute lower abdominal pain. Diagnostic indicators of appendicitis and OB-GYNc were identified by stepwise multivariable polytomous logistic regression. Diagnostic performances of the scores were tested. Result. The developed clinical score is comprised of (1) guarding or rebound tenderness, (2) pregnancy, (3) sites of abdominal tenderness, (4) leukocytosis, (5) peripheral neutrophils ≥75%, and (6) presence of diarrhea. For diagnosis of appendicitis, the area under the ROC curve was 0.8696, and the sensitivity and specificity were 89.25% and 70.00%. For OB-GYNc, the corresponding values were 0.8450, 66.67%, and 94.85%, respectively. Conclusion. The clinical scoring system can differentiate the diagnosis of acute lower abdominal pain in young adult females. Time spent for diagnosis at the emergency room may be shortened, and the patients would be admitted to the appropriate departments in less time.

Highlights

Diagnosis of acute lower abdominal pain in young adult female is a clinical challenge
Previous studies showed that some clinical indicators were helpful to distinguish appendicitis and common obstetrics and gynecological conditions (OB-GYNc) from nonspecific abdominal pain (NSAP) [3]
The objective of the present study was to develop a clinical scoring for diagnosis of acute lower abdominal pain in females of reproductive age that could either have appendicitis, OB-GYNc, or NSAP

Summary

Introduction

Diagnosis of acute lower abdominal pain in young adult female is a clinical challenge. Appendicitis and obstetrics and gynecological conditions (OB-GYNc), such as ectopic pregnancy, pelvic inflammatory diseases, and complicated ovarian cyst, are common causes of acute lower abdominal pain in females during reproductive age [1]. Experienced emergency physicians can detect important clinical findings and give a provisional diagnosis to a patient before transferring her to general surgery or obstetrics and gynecology departments according to their judgment. Previous studies showed that some clinical indicators were helpful to distinguish appendicitis and common obstetrics and gynecological conditions (OB-GYNc) from nonspecific abdominal pain (NSAP) [3]. Obstetrics and gynecological conditions (OB-GYNc) are difficult to be differentiated from appendicitis in young adult females presenting with acute lower abdominal pain. The clinical scoring system can differentiate the diagnosis of acute lower abdominal pain in young adult females. Time spent for diagnosis at the emergency room may be shortened, and the patients would be admitted to the appropriate departments in less time

Objectives

Methods

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Conclusion