• Gheorghe Nicusor Pop, Flaviu Octavian Costea, Diana Lungeanu, Emil Radu Iacob, and Calin Marius Popoiu.
• Victor Babeş University of Medicine and Pharmacy, Timişoara, Romania.
• Singap Med J. 2022 Jan 1; 63 (1): 35-41.

IntroductionThis study aimed to investigate the ultrasonographic features of paediatric acute appendicitis and incorporate them into a scoring algorithm that will quantify the risk of complications and the strength of recommendation for surgical intervention.Methods179 patients with suspected appendicitis who had undergone ultrasonographic examination were included in this study. Based on their medical evaluation and post-surgical histopathological results, patients were categorised into confirmed appendicitis (n = 101) and non-appendicitis (n = 78) groups.ResultsIn the appendicitis group, the appendix was visualised in 66 (65.3%) patients. In cases where the appendix was not visualised, we looked out for secondary inflammatory signs, which were present in 32 (31.7%) patients. Using stepwise logistic regression, Blumberg's sign, free fluid or collection, hyperaemia, non-compressible appendix and an appendix diameter > 7 mm were found to be significant predictive factors for appendicitis. A new scoring system called POPs was developed, combining inflammatory predictors and ultrasonography findings, with an area under the receiver operating characteristic curve of 0.958 (95% confidence interval 0.929-0.986).ConclusionThe newly developed POPs-based diagnosis scheme proved a promising alternative to existing scoring systems such as the Alvarado score. Although further calibration would be beneficial, the proposed scoring scheme is simple and easy to understand, memorise and apply in the emergency room.Copyright: © Singapore Medical Association.

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