Diagnosis of acute appendicitis in children using anal sphincteromanometry
DOI:
https://doi.org/10.15574/PS.2025.3(88).4146Keywords:
acute appendicitis, anal sphincteromanometry, childrenAbstract
The problem of acute appendicitis (АА) early diagnosis in children of different age groups remains relevant. According to the updated WSES 2020 Jerusalem guidelines for the diagnosis and treatment of АА in children, there is currently no reliable data to suggest the best diagnostic pathway.
Аim - determine the effectiveness of AA diagnosis in children using anal sphincteromanometry.
Materials and methods. 107 children underwent pressure measurement in the anal canal. Patients undergoing anal sphincteromanometry were divided into 2 groups homogeneous in age and gender. Group I consisted of 52 children who were hospitalised with АА with an Alvarado and PAS scales of 8-10 points (probable АА). Group II consisted of 57 children who were hospitalised with suspected AA and an Alvarado scale of <5 points and a PAS scale of 1-3 points, in whom AA diagnosis was excluded.
Results. In group I children, the resting pressure was 65.87±1.52 mmHg, pressure at palpation of the right hypochondrium 90.2±2.93 mmHg, pressure at determination of the Blumberg’s sign 100.67±4.68 mmHg, pressure during palpation on the left side 90.87±2.69 mmHg. In group II children, the resting pressure was 40.63±1.99 mmHg, and did not change significantly during abdominal palpation. On the 5th day of the postoperative period, the operated children underwent a control determination of anal sphincteromanometry, which demonstrated a significant decrease in anal pressure.
Conclusions. Anal sphincteromanometry, combined with objective examination and other additional examination methods, increases the effectiveness of AA diagnosing in children.
The study was performed in accordance with Helsinki Declaration principles. The study protocol was approved by the Local Ethics Committee for all participants.
The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
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