Impact and frequency of misdiagnosis of appendicitis in pediatric patients with gastroenteritis in a developing country
Aim: Appendicitis manifests with atypical symptoms in a large percentage of patients, leading to diagnostic errors that delay diagnosis. This study aimed to evaluate the impact and frequency of appendicitis being incorrectly diagnosed as gastroenteritis in a developing country. Methods: This prospec...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-03-01
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| Series: | Global Pediatrics |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667009725000028 |
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| author | Pastor Escárcega-Fujigaki Guillermo Hernández-Peredo-Rezk Gerardo Alonso-Acosta Keren-Hapuc Vargas-Amador |
| author_facet | Pastor Escárcega-Fujigaki Guillermo Hernández-Peredo-Rezk Gerardo Alonso-Acosta Keren-Hapuc Vargas-Amador |
| author_sort | Pastor Escárcega-Fujigaki |
| collection | DOAJ |
| description | Aim: Appendicitis manifests with atypical symptoms in a large percentage of patients, leading to diagnostic errors that delay diagnosis. This study aimed to evaluate the impact and frequency of appendicitis being incorrectly diagnosed as gastroenteritis in a developing country. Methods: This prospective, comparative study included 207 pediatric patients with appendicitis divided into two groups: group A, with 117 (56.5 %) patients with diagnostic errors, and group B, with 90 (43.4 %) patients without diagnostic errors. Clinical, laboratory, and imaging data were compared using the Mann–Whitney tests, odds ratio (OR), and 95 % confidence interval (CI) with statistical significance set at p-value <0.05. Results: The diagnosis was confused with gastroenteritis in 66 (56.4 %) patients, causing a delay in surgical management, which was statistically significant (OR: 2.25; 95 % CI: 1.23–4.09; p < 0.005) when compared with group B. The second most common cause of confusion was colitis, which was observed in 40 (34.2 %) patients. Group A had a large number of perforated appendicitis cases (OR: 3.22; 95 % CI: 1.81–5.72; p < 0.01), with more days till oral administration initiation (OR: 3.68; 95 % CI: 1.32–10.27; p < 0.01) and longer hospital stays (OR: 6.83; 95 % CI: 1.85–25.11; p < 0.01). Furthermore, general practitioners more frequently had diagnostic errors than pediatricians (OR: 0.17; 95 % CI: 0.07–0.43; p < 0.01). Conclusions: The diagnosis of appendicitis was confused with gastroenteritis or colitis in majority of pediatric patients. Practitioners should be aware of the possibility of appendicitis in patients presenting with abdominal pain, diarrhea, or fever. Level of Evidence: III |
| format | Article |
| id | doaj-art-c144cd4c5fbc4b82b2f7a87faf0e0405 |
| institution | Kabale University |
| issn | 2667-0097 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Global Pediatrics |
| spelling | doaj-art-c144cd4c5fbc4b82b2f7a87faf0e04052025-01-23T05:27:52ZengElsevierGlobal Pediatrics2667-00972025-03-0111100244Impact and frequency of misdiagnosis of appendicitis in pediatric patients with gastroenteritis in a developing countryPastor Escárcega-Fujigaki0Guillermo Hernández-Peredo-Rezk1Gerardo Alonso-Acosta2Keren-Hapuc Vargas-Amador3Department of Pediatric Surgery, Centro de Alta Especialidad Dr. Rafael Lucio, Av Adolfo Ruiz Cortines, 2903, col. Unidad Magisterial, Xalapa, Veracruz 91193, Mexico; Corresponding author at: Department of Pediatric Surgery, Centro de Alta Especialidad Dr. Rafael Lucio, Av Adolfo Ruiz Cortines, 2903, col. Unidad Magisterial, Xalapa, Veracruz 91193, Mexico.Department of Pediatric Surgery, Centro de Alta Especialidad Dr. Rafael Lucio, Av Adolfo Ruiz Cortines, 2903, col. Unidad Magisterial, Xalapa, Veracruz 91193, MexicoDepartment of Cardiology, Centro de Alta Especialidad Dr. Rafael Lucio, Xalapa, Veracruz, MexicoDepartment of Medical Pediatrics, Centro de Alta Especialidad Dr. Rafael Lucio, Xalapa, Veracruz, MexicoAim: Appendicitis manifests with atypical symptoms in a large percentage of patients, leading to diagnostic errors that delay diagnosis. This study aimed to evaluate the impact and frequency of appendicitis being incorrectly diagnosed as gastroenteritis in a developing country. Methods: This prospective, comparative study included 207 pediatric patients with appendicitis divided into two groups: group A, with 117 (56.5 %) patients with diagnostic errors, and group B, with 90 (43.4 %) patients without diagnostic errors. Clinical, laboratory, and imaging data were compared using the Mann–Whitney tests, odds ratio (OR), and 95 % confidence interval (CI) with statistical significance set at p-value <0.05. Results: The diagnosis was confused with gastroenteritis in 66 (56.4 %) patients, causing a delay in surgical management, which was statistically significant (OR: 2.25; 95 % CI: 1.23–4.09; p < 0.005) when compared with group B. The second most common cause of confusion was colitis, which was observed in 40 (34.2 %) patients. Group A had a large number of perforated appendicitis cases (OR: 3.22; 95 % CI: 1.81–5.72; p < 0.01), with more days till oral administration initiation (OR: 3.68; 95 % CI: 1.32–10.27; p < 0.01) and longer hospital stays (OR: 6.83; 95 % CI: 1.85–25.11; p < 0.01). Furthermore, general practitioners more frequently had diagnostic errors than pediatricians (OR: 0.17; 95 % CI: 0.07–0.43; p < 0.01). Conclusions: The diagnosis of appendicitis was confused with gastroenteritis or colitis in majority of pediatric patients. Practitioners should be aware of the possibility of appendicitis in patients presenting with abdominal pain, diarrhea, or fever. Level of Evidence: IIIhttp://www.sciencedirect.com/science/article/pii/S2667009725000028AppendicitisDiarrheaAbdominal painAcute abdomen |
| spellingShingle | Pastor Escárcega-Fujigaki Guillermo Hernández-Peredo-Rezk Gerardo Alonso-Acosta Keren-Hapuc Vargas-Amador Impact and frequency of misdiagnosis of appendicitis in pediatric patients with gastroenteritis in a developing country Global Pediatrics Appendicitis Diarrhea Abdominal pain Acute abdomen |
| title | Impact and frequency of misdiagnosis of appendicitis in pediatric patients with gastroenteritis in a developing country |
| title_full | Impact and frequency of misdiagnosis of appendicitis in pediatric patients with gastroenteritis in a developing country |
| title_fullStr | Impact and frequency of misdiagnosis of appendicitis in pediatric patients with gastroenteritis in a developing country |
| title_full_unstemmed | Impact and frequency of misdiagnosis of appendicitis in pediatric patients with gastroenteritis in a developing country |
| title_short | Impact and frequency of misdiagnosis of appendicitis in pediatric patients with gastroenteritis in a developing country |
| title_sort | impact and frequency of misdiagnosis of appendicitis in pediatric patients with gastroenteritis in a developing country |
| topic | Appendicitis Diarrhea Abdominal pain Acute abdomen |
| url | http://www.sciencedirect.com/science/article/pii/S2667009725000028 |
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