R.F. MAKHMUTOV, G.A. NOVIKOV 

1. Gorky Donetsk State Medical University, Donetsk

Contact details:

Makhmutov R.F. — MD, Professor of the Department of Pediatrics № 2

Address: 16 prospekt Illyicha, 283003 Donetsk, Russian Federation, tel.: +7-856-297-89-01, e-mail: ravilclassic@yandex.com

 The article presents a review of domestic and foreign literature on the modern laboratory and instrumental methods of diagnosing acute appendicitis in pre-school children. There is a high level of diagnostic errors, unreasonable surgical interventions and postoperative complications in the pediatric population. Currently, the clinical symptoms have the greatest diagnostic value, although their reliability is disputable. According to some authors, clinical laboratory data, including the level of leukocytes, are not specific to this pathology. The study of acute phase proteins for diagnosing complicated appendicitis is encouraging and relevant. Highly informative noninvasive instrumental diagnostic methods (sonography, computed tomography, magnetic resonance imaging) have limitations. It is necessary to systematize and improve simple and accessible diagnostic methods to form new criteria for assessing the course of acute appendicitis and predicting its complicated forms.

Key words: acute appendicitis, appendectomy, diagnosis, complications, children.

REFERENCES

1. Shamsiev R.E., Garifullina G.I., Abdullina A.S. et al. Analiz chastoty vstrechaemosti razlichnykh form appenditsita sredi drugikh ostrykh khirurgicheskikh zabolevaniy organov bryushnoy polosti [Analysis of the incidence of various forms of appendicitis among other acute surgical diseases of the abdominal organs]. Sovremennye nauchnye issledovaniya: aktual’nye voprosy, dostizheniya i innovatsii: sb. st. VIII Mezhdunarod. nauchno-prakt. konf. Penza, 2019. Pp. 292–293.
2. Stavinskiy R.A., Dolgov Yu.A., Lefter G.D. Method for diagnosing acute appendicitis. Khirurgiya. Zhurnal im. N.I. Pirogova, 2010, no. 12, pp. 51–52 (in Russ.).
3. Rotkov I.L. Diagnosticheskie i takticheskie oshibki pri ostrom appenditsite [Diagnostic and tactical errors in acute appendicitis]. Moscow: Meditsina, 1980. 208 p.
4. Kasimov R.R., Mukhin A.S. Current state of diagnostics of acute appendicitis. Sovremennye tekhnologii v meditsine, 2013, no. 5, pp. 112–117 (in Russ.).
5. Messer N., Benov A., Rov A. et al. Poor compliance to clinical guidelines in the diagnosis of acute appendicitis: insights from a national survey. J. Clin. Med, 2024, vol. 13, r. 2862.
6. Ghidini F., Virgone C., Donà D. et al. Complicated acute appendicitis in children: the importance of stewarding antibiotic prescriptions. Turk. J. Pediatr, 2022, vol. 64 (5), pp. 839–847.
7. Filenko B.P., Mammaeva Z.N. Acute appendicitis in children masquerading as acute intestinal infection. E-Scio, 2021, no. 2, pp. 592–602 (in Russ.).
8. Cameron D.B., Anandalwar S.P., Graham D.A. et al. Development and implications of an evidence-based and public health-relevant definition of complicated appendicitis in children. Ann Surg, 2020, vol. 271, rr. 962–968.
9. Wee J.J., Park C.J., Lee Y.T. et al. A simple classification of peritoneal contamination in perforated appendicitis predicts surgery-related complications. J. Paediatr. Child Health, 2020, vol. 56, rr. 272–275.
10. Feng C., Anandalwar S., Sidhwa F. et al. Beyond perforation: Influence of peritoneal contamination on clinical severity and resource utilization in children with perforated appendicitis. J. Paediatr. Child Health, 2016, vol. 51, rr. 1896–1899.
11. Shulutko A.M., Nasirov F.N., Natroshvili A.G. Is ultrasound examination necessary in the diagnosis of acute appendicitis? Meditsinskaya vizualizatsiya, 2001, no. 3, pp. 52–57 (in Russ.).
12. Kokhreidze N.A., Kutusheva G.F., Yarova L.M. Use of scoring scales in the differential diagnosis of complicated forms of acute appendicitis and acute inflammation of the uterine appendages in girls. Detskaya khirurgiya, 2016, no. 3, pp. 135–139 (in Russ.).
13. Kriger A.G., Fedorov A.V., Voskresenskiy P.K. et al. Ostryy appenditsit [Acute appendicitis]. Moscow: Medpraktika-M, 2002. 244 p.
14. Evtikhov R.M., Shulutko A.M., Zhuravlev V.A. et al. Khirurgicheskie bolezni [Surgical diseases]. Ivanovo: MIK, 1998. 333 p.
15. Shozo Y., Katsunari T., Tsukasa H. et al. C-Reactive protein is an independent surgical indication marker for appendicitis: a retrospective study. World J. Emerg. Sur, 2009, vol. 4, r. 36.
16. Hart W.R. C-reactive protein: the best laboratory indicator available for monitoring disease activity. Cleve Clin J Med, 1989, vol. 56, rr. 126–130.
17. Agrawal C.S., Adhikari S., Kumar M. Role of serum C-reactive protein and leukocyte count in the diagnosis of acute appendicitis in Nepalese population. Nepal Med. Coll J, 2008, vol. 10, rr. 11–15.
18. Shafi S.M., Afsheen M., Reshi F.A. Total leucocyte count, C-reactive protein and neutrophil count: diagnostic aid in acute appendicitis. Saudi Y gastroenterol, 2009, vol. 15, rr. 117–120.
19. Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann. Emerg. Med, 1986, vol. 15, rr. 557–564.
20. Endovideoskopicheskie i rentgenokhirurgicheskie vmeshatel’stva na organakh zhivota, grudi i zabryushinnogo prostranstva: ch. 2, pod red. A.E. Borisova [Endovideoscopic and X-ray surgical interventions on the abdominal, chest and retroperitoneal organs: Part 2, edited by A.E. Borisov]. Saint Petersburg: Skifiya-print, 2006. 400 p.
21. Sinenchenko G.I., Kurygin A.A., Bagnenko S.F. Khirurgiya ostrogo zhivota [Surgery of acute abdomen]. Saint Petersburg: Elbi-SPb, 2007. 512 p.
22. Yartsev P.A., Ermolov A.S., Pakhomova G.V. Laparoscopy in diagnostics and treatment of acute appendicitis. Khirurgiya. Zhurnal im. N.I. Pirogova, 2010, no. 4, pp. 21–25 (in Russ.).
23. Kulezneva Yu.V., Izrailov R.E., Lemeshko Z.A. Ul’trazvukovoe issledovanie v diagnostike i lechenii ostrogo appenditsita [Ultrasound in diagnostics and treatment of acute appendicitis]. Moscow: GEOTAR-Media, 2009. 72 p.
24. Jay K., Harness J.K., Wisher D.V. Ultrasound in surgical practice: basic principles and clinical applications. N.Y.: Wiley-Liss, 2001. 529 p.
25. Soda K., Nemoto K., Yoshizawa S. Detection of pinpoint tenderness on the appendix under ultrasonography is useful to confirm acute appendicitis. J. Pediatr. Surg, 2001, vol. 136, rr. 1136–1140.
26. Comune R., Tamburrini S., Durante A. et al. Ultrasonography (US) examination of acute appendicitis (AA): diagnosis of complicated and uncomplicated forms and when US is not enough. J. Med. Imaging Intervent Radiol, 2024, vol. 11, r. 14.
27. Bonomo R.A., Tamma P.D., Abrahamian F.M. et al. 2024 Clinical practice guideline update by the infectious diseases Society of America on complicated intra-abdominal infections: diagnostic imaging of suspected acute appendicitis in adults, children, and pregnant people. Clin. Infect. Dis, 2024, vol. 79 (suppl. 3), rr. S94–S103.
28. Rezak A., Abbas H.M.A., Ajemian M.S. Decreased use of computed tomography with a modified clinical scoring system in diagnosis of pediatric acute appendicitis. J. Pediatr. Surg, 2011, vol. 146, rr. 64–67.
29. Paulson E.K., Kalady M.F., Pappas T.N. Suspected Appendicitis. New Engl. J. Med, 2003, vol. 16, rr. 236–242.
30. Mishra R.K., Hanna G.B., Cuschieri A. Laparoscopic versus open appendectomy for the treatment of acute appendicitis. World J. Laparoscopic Sur, 2008, vol. 1, rr. 19–28.
31. Efimenko N.A., Chursin V.V., Stepnov A.A. et al. Therapeutic and diagnostic laparoscopy for appendicitis. Voenno-meditsinskiy zhurnal, 2007, no. 8, pp. 19–23 (in Russ.).
32. Shangareeva R.Kh., Demina A.V., Nigamet’yanov R.A. et al. Preoperative complications in acute appendicitis in children. Rossiyskiy vestnik detskoy khirurgii, anesteziologii i reanimatologii, 2023, vol. 13, no. S, p. 204 (in Russ.).