Evaluation of the Management of Acute Appendicitis Before Emergency Department in Children: a Prospective Study

Acute appendicitis is the first visceral surgical emergency in pediatrics with about 30,000 cases in children having been described in France. It concerns 0.3% of children under 15 with a maximum frequency between 8 and 13 years of age. Acute appendicitis has a significant morbidity rate of 8% and a mortality rate under 0.1%. 10 to 25% of the children admitted to emergency rooms for abdominal pain have appendicitis. In 20 to 30% of the cases, the initial symptoms are atypical, which explains the difficulty in diagnosing. The purpose of our study is to evaluate the quality of general practitioners in the diagnosis of acute appendicitis, its severity and the diagnostic criteria used. Furthermore, it is not as easy to evaluate pain or examine a complaint in children as it is in adults. Appendicectomy is the treatment of choice for all acute appendicitis. The importance of early diagnosis and treatment is, therefore, essential. Many predictive diagnostic scores have been studied over the years. The Pediatric Appendicitis Score (PAS) using typical symptoms of acute appendicitis and biological items was published in 2002. Nowadays, it is still considered as a reference and has been validated by other studies. Most of the patients suffering from abdominal pain first consult their general practitioner.