Comparison of clinical characteristics and neutrophil values in omental infarction and acute appendicitis in children.
BACKGROUND
Omental infarction is a rare occurrence in children. It is often diagnosed during surgery for suspected appendicitis. This study investigated the use of clinical and laboratory data for distinguishing between omental infarction and acute appendicitis.


METHODS
Seven patients with surgically and pathologically proven omental infarction and 28 age- and sex-matched patients with acute appendicitis were included in this study. The clinical characteristics, imaging study results and laboratory data were analyzed.


RESULTS
All 35 patients had right lower quadrant abdominal pain at presentation. The frequency of nausea and fever were significantly lower in the omental infarction group compared with the acute appendicitis group (p< 0.001 and p= 0.018, respectively). In laboratory studies, the white blood cell count, C-reactive protein value and neutrophil percentage were all higher in the acute appendicitis group compared with the omental infarction group (p= 0.001, p< 0.001, and p= 0.008, respectively). It was possible to separate patients with omental infarction from those with acute appendicitis based on a neutrophil percentage of less than 77% (sensitivity 100%, specificity 100%).


CONCLUSIONS
Results of the current study suggest that omental infarction should be considered as a possible diagnosis in patients presenting with right lower quadrant abdominal pain without nausea or fever, and with a neutrophil percentage below 77%.
Yang
Ya-Ling
YL
Department of Anesthesiology, Chang Gung Memorial Hospital-Kaohsiung Medical Center and the Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taiwan.
Huang
Ying-Hsien
YH
Tiao
Mao-Meng
MM
Tang
Kuo-Shu
KS
Huang
Fu-Chen
FC
Lee
Shin-Yi
SY
D000006:Abdomen, Acute / Q000097:blood / Q000175:diagnosis*; D001062:Appendectomy; D001064:Appendicitis / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D003937:Diagnosis, Differential; D006801:Humans; D007238:Infarction / Q000097:blood / Q000175:diagnosis*; D007958:Leukocyte Count; D009504:Neutrophils; D009852:Omentum / Q000098:blood supply*; D012372:ROC Curve; D012680:Sensitivity and Specificity
D015415:Biomarkers; D002097:C-Reactive Protein