Qui corporum vires ex mole, figura, et velocitate, vel assumtis, vel deprehensis observatione, calculo aestimant Geometrico, Mechanici appellantur. Quos ipse Artis usus, claraque demonstratae veritatis lux, Sapientibus adeo commendavit, ut aliam omni aeque laudatam seculo, omni aeque comprobatam suffragio, temere non inveneris. Miram profecto, et insperato rei eventu humana fere altiorem Sapientiam! - Hermanni Boerhaave                                    

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Appendicitis
De berekening van de kans op appendicitis wordt gemaakt op basis van resultaten uit 17 betrouwbare studies. Het algoritme extraheert deze gegevens uit de database en berekent nakansen aan de hand van voorkansen en positieve en negatieve likelihoodratio's. De uitkomst van de berekening is uiteraard een statistische inschatting en onderhevig aan diverse onzekerheden. Lees over de belangrijke statistische tekortkomingen.

De gemiddelde voorkans in de gebruikte studies is 1.6 %

Inclusie criteria in gebruikte studies: Acute abdominal pain 

Anamnese

Nausea
Verplaatsen van de pijn
Koorts
Anorexie
Braken
Diarree

Klinische tekens

Psoas teken
Loslaatpijn
Pijn in rechter fossa abdominalis

Aanvullende onderzoeken

Echografie voor appendicitis
Leukocytosis (> 10000 / ml)


Studies gebruikt in deze berekening

1.David G. Bundy et al. Does This Child Have Appendicitis? JAMA. 2007 Jul 25; 298(4): 438–451.
2.Wagner JM et al. Does This Patient Have Appendicitis? JAMA. 1996;276(19):1589-1594
3.Hardin M et al. Acute Appendicitis: Review and Update. Am Fam Physician. 1999 Nov 1;60(7):2027-2034
4.Nshuti R et al. Clinical presentation of acute appendicitis in adults at the Chris Hani Baragwanath academic hospital. Int J Emerg Med. 2014; 7: 12
5.Lamture YR et al. The role of rebound tenderness in acute appendicitis and appendicular perforation. Int Surg J. 2017 Feb;4(2):725-727
6.Idris SA et al. The sensitivity and specificity of the conventional symptoms and signs in making adiagnosis of acute appendicitis. Sudan journal of medical sciences. 4. 55-61
7.Al-gaithy Zuhoor K et al. Clinical value of total white blood cells and neutrophil counts in patients with suspected appendicitis: retrospective study. World Journal of Emergency Surgery : WJES. 2012;7:32
8.Al-Ajerami Y et al. Sensitivity and specificity of ultrasound in the diagnosis of acute appendicitis. East Mediterr Health J. 2012 Jan;18(1):66-9
9.Al-Khayal KA et al. Computed tomography and ultrasonography in the diagnosis of equivocal acute appendicitis. A meta-analysis. Saudi Med J. 2007 Feb;28(2):173-80
10.Toorenvliet BR et al. Routine ultrasound and limited computed tomography for the diagnosis of acute appendicitis. World J Surg 34(10):2278, October 2010
11.Neufeld D et al. Management of acute appendicitis: an imaging strategy in children. Ped Surg Internat 26(2):167, February 2010
12.Doria AS et al. US or CT for diagnosis of appendicitis in children and adults? A meta-analysis. Radiology 241(1):83, October 2006
13.Saaiq M et al. Diagnostic Accuracy of Leukocytosis in Prediction of Acute Appendicitis. Journal of the College of Physicians and Surgeons Pakistan 2014, Vol. 24 (1): 67-69
14.Dahmardehei M et al. Diagnostic Value of Leukocytosis, ESR and CRP in Patients with Suspected Acute Appendicitis. Zahedan J Res Med Sci 2013 Jul; 15(7): 59-63
15.Kamran H et al. Role of total leukocyte count in diagnosis of acute appendicitis. J Ayub Med Coll Abbottabad 2008;20(3)
16.Hastings RS et al. Abdominal pain in the ED: a 35 year retrospective. Am J Emerg Med. 2011 Sep;29(7):711-6
17.Caporale N et al. Acute abdominal pain in the emergency department of a university hospital in Italy. United European Gastroenterology Journal 2016, Vol. 4(2) 297–304


Berekende kans

1.6 %