The relationship between blood test, pas score and outer diameter of the appendix in the diagnosis of pediatric acute appendicitis

Acute appendicitis is the common cause of surgery for acute abdominal pain in children. We ought to assess the relationship between white blood cell count, PAS (pediatric appendicitis score) clinical scoring and the measurement of the outer diameter of the appendix. This study includes 480 pediatric patients who underwent surgery for suspected acute appendicitis at the General Surgery Department of the National Center for Maternal and Child Health hospital between May 2019 and December 2019. Clinical diagnosis was conducted using the PAS score based on the pre-operative blood test results including white blood cells count, neutrophil count, lymphocytes count, and neutrophil-lymphocytes ratio (NLR) . The diameter of the appendix was determined by ultrasound (US). A total of 516 children (18 years old) underwent surgical removal of the appendix following the suspicion of acute appendicitis. PAS and NLR, and PAS and outer diameter of the appendix are been with middle correlation to each others.(r=0.494 and r=0.437) But NLR and outer diameter of the appendix are poor correlation.(r=0.169). In cases with an outer appendix diameter 6mm, 44% were inflamed and 56% were not. This diagnostic accuracy can be enhanced with the combined use of the PAS system and the assessment of the neutrophil-lymphocyte ratio.