Evaluation of Pressure Algometry in the Clinical Assessment of Acute Abdominal Pain in Children

As a retrospective cohort study, participants include all children referred with abdominal pain from January 2000 to June 2006 to one surgeon (R.P.) on the pediatric general surgery service at the Health Sciences Centre (HSC)-Children's Hospital in Winnipeg. The HSC-Children's Hospital is the only pediatric surgery centre within a radius of 600 km. All included participants have had acute abdominal pain ≤ 7 days, and suspected appendicitis based on standard history and physical exam. Standard appendicitis treatments were used: analgesia, antibiotics, operation. The Research Ethics Board of the University of Manitoba approved the study and reporting of the findings (H2003:104).

The investigators use standard clinical, laboratory, diagnostic imaging procedures for appendicitis diagnosis. The final diagnosis is defined by:

• pathology report indicating transmural inflammation, or
• from the surgeon's report when pathology was unavailable, or
• by discharge diagnosis in non-operated patients.

Appendix rupture is defined by the presence of pus and full-thickness perforation of the appendix wall or abscess formation at operation or on pathology examination. The appendix condition is classified as normal, non-perforated or perforated; all other pathologies at operation are recorded. Treatments, complications and morbidity are tabulated.

Clinical Measures