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Surgery Research and Practice
Volume 2014 (2014), Article ID 438076, 6 pages
Research Article

Appendicitis in Children: Evaluation of the Pediatric Appendicitis Score in Younger and Older Children

1Department of Clinical Sciences, Lund University and Department of Pediatric Surgery, Skåne University Hospital, 221 85 Lund, Sweden
2Department of Clinical Sciences, Lund University and Division of Internal Medicine, Skåne University Hospital, 205 02 Malmö, Sweden

Received 24 August 2014; Revised 12 November 2014; Accepted 25 November 2014; Published 10 December 2014

Academic Editor: Moritz M. Ziegler

Copyright © 2014 Martin Salö et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. This study aimed to evaluate Pediatric Appendicitis Score (PAS), diagnostic delay, and factors responsible for possible late diagnosis in children <4 years compared with older children who were operated on for suspected appendicitis. Method. 122 children, between 1 and 14 years, operated on with appendectomy for suspected appendicitis, were retrospectively analyzed. The cohort was divided into two age groups: ≥4 years () and <4 years (). Results. The mean PAS was lower among the younger compared with the older patients (5.3 and 6.6, resp.; ), despite the fact that younger children had more severe appendicitis (75.0% and 33.3%, resp.; ). PAS had low sensitivity in both groups, with a significantly lower sensitivity among the younger patients. Parent and doctor delay were confirmed in children <4 years of age with appendicitis. PAS did not aid in patients with doctor delay. Parameters in patient history, symptoms, and abdominal examination were more diffuse in younger children. Conclusion. PAS should be used with caution when examining children younger than 4 years of age. Diffuse symptoms in younger children with acute appendicitis lead to delay and to later diagnosis and more complicated appendicitis.