The Diagnostic Role of Ultrasonography and Neutrophil-to-Lymphocyte Ratio in Acute Abdominal Pain in Children

Year 2025, Volume: 35 Issue: 1, 142 - 149, 28.02.2025

Esra Babayiğit , Fatih Akın , Süleyman Bakdık , Abdullah Akkuş , Ahmet Osman Kılıç , Abdullah Yazar

https://doi.org/10.54005/geneltip.1574404

Abstract

Abstract:
Background: Acute abdominal pain in children is typically a transient condition with age-dependent symptoms, but in some cases, it can lead to serious outcomes requiring urgent medical intervention. Early diagnosis, treatment are crucial to preventing complications. When physical examination alone is insufficient, diagnostic tools such as ultrasonography and laboratory tests, including the neutrophil-to-lymphocyte ratio (NLR), can enhance diagnostic accuracy.
Materials and Methods: This prospective study included children aged 0-18 years who presented to the Pediatric Emergency Department at Necmettin Erbakan University Faculty of Medicine with acute abdominal pain lasting less than three days, between January and December 2022. All patients underwent abdominal ultrasonography. Laboratory test results, ultrasound findings, and pathological examination results were recorded from the hospital database. The ultrasonographic criteria for diagnosing appendicitis were defined as an appendix larger than 6 mm or surrounded by a hypoechoic wall thicker than 2 mm.
Results: A specific diagnosis was established in 53.4% of the 504 patients. The most common diagnoses were mesenteric lymphadenitis, gastroenteritis, and appendicitis. In 46.6% of the cases, no specific diagnosis was made, and these were classified as nonspecific abdominal pain. Patients with organic abdominal pain had significantly higher NLR, white blood cell counts, and C-reactive protein levels than those with nonspecific pain (p<0.05). Patients requiring surgery were older, had higher NLR, white blood cell and neutrophil counts, and lower lymphocyte counts compared to those who did not require surgery (p<0.05). The sensitivity of ultrasonography in diagnosing appendicitis was 60.9%, with a specificity of 33.3%.
Conclusion: Ultrasonography is a frequently used method in the diagnosis of acute abdominal pain in children; however, the inability to visualize the appendix may make diagnosis difficult. Neutrophil lymphocyte ratio increases diagnostic accuracy in cases requiring urgent surgical intervention, and the combined use of both methods allows faster and more accurate results

Keywords

acute abdominal pain, ultrasonography, neutrophil-to-lymphocyte ratio

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