Negative appendicectomy rates in adolescent girls compared with boys: The role of ultrasound and serum inflammatory markers
Background Adolescent girls are frequently seen with more differentials for abdominal pain than boys. We aim to determine if this infers that a negative appendectomy (NA) is more likely in girls, and if the use of ultrasonography
(USS) and inflammatory markers reduce the likelihood of a NA.
Participants and methods Over a 17-year period, we reviewed the histology of appendix specimens removed nonincidentally from adolescents aged 12–16 years. Specimens with normal histology were grouped as NAs. The preoperative white cell count, C-reactive protein and USS were analysed.
Results Data were available for 430 boys and 273 girls. The overall NA rate was 9.1%, with 7.2 and 12.1% in boys and girls, respectively. This represented an increased odds of a NA in girls [odds ratio (OR): 1.77, 95% confidence interval (95% CI): 1.06–2.96; P = 0.030]. When the variance in the preoperative use of USS and inflammatory markers was accounted for, the new odds of a NA in girls compared with boys were now not significantly increased (OR: 2.27, 95% CI:0.09–60.64; P = 0.624). USS did not significantly reduced the odds of a NA (OR: 0.98, 95% CI: 0.48–2.02; P=0.960). There were significantly increased odds of a NA in adolescents with normal white cell count and C-reactive protein (OR: 15.84, 95% CI: 2.12–118.50; P = 0.007).
Conclusion Adolescent girls are more likely to undergo a NA. When inflammatory markers are elevated, this increased likelihood of a NA is not seen in girls, but rather reduced odds of a NA are seen in both girls and boys. adolescents, boys, girls, inflammatory markers, negative appendicectomy, ultrasonography
Keywords: adolescents, boys, girls, inflammatory markers, negative appendicectomy, ultrasonography