Different urinalysis appearances in children with simple and perforated appendicitis.
OBJECTIVE
This study aimed to determine whether routine urinalysis may serve as a tool in discriminating between acute appendicitis and perforated appendicitis in children.


METHODS
We prospectively collected 357 patients with clinically suspected acute appendicitis. Urinalysis was performed in patients with clinically suspected acute appendicitis before surgical intervention. Routine urinalysis is composed of 2 examinations: chemical tests for abnormal chemical constituents and microscopic tests for abnormal insoluble constituents. Receiver operating characteristic curves for urine white blood cell (WBC) counts and urine red blood cell (RBC) counts in distinguishing between patients with simple appendicitis and patients with perforated appendicitis were also analyzed.


RESULTS
Urine ketone bodies, leukocyte esterase, specific gravity, pH, WBC, and RBC counts were all significant parameters among patients with normal appendices, simple appendicitis, and perforated appendicitis (all P < .05). Based on multivariate logistic regression analysis, positive urine ketone bodies and nitrate were significant parameters in predicting perforated appendicitis (P = .002 and P = .008, respectively). According to the results of receiver operating characteristic curves, the appropriate cutoff values were 2.0/high-power field for urine RBC counts and 4.0/high-power field for urine WBC counts in predicting perforated appendicitis in children.


CONCLUSIONS
Routine urinalysis may serve to aid in discriminating between simple and perforated appendicitis. Clinically, we believe that these urine parameters may aid primary emergency physicians with decision making in patients with clinically suspected appendicitis.
Department of Pediatrics, Changhua Christian Hospital, Changhua, Taiwan, ROC; School of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC.
Chun-Yu
CY
Chen
Lu-Lu
LL
Zhao
Yan-Ren
YR
Lin
Kang-Hsi
KH
Wu
Han-Ping
HP
Wu
D001064:Appendicitis / Q000175:diagnosis / Q000652:urine*; D002265:Carboxylic Ester Hydrolases / Q000652:urine; D002648:Child; D004906:Erythrocyte Count; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007657:Ketone Bodies / Q000652:urine; D007958:Leukocyte Count; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013046:Specific Gravity; D016482:Urinalysis / Q000379:methods
D007657:Ketone Bodies; C021443:leukocyte esterase; D002265:Carboxylic Ester Hydrolases