1439 Table 1Histologically positive appendectomies and PAS interpretationHistologically positive and PAS PRE-Covid Post-initial wave Total 0–2 0 0 0 3–6 1 (100%) 2 (66.7%) 3 (75%) 7+ 5 (100%) 13 (92.3%) 18 (94.5%) Not adhered 3 (75%) 4 (100%) 7 (87.5%) ConclusionsOnly a small proportion of children presenting to secondary care with abdominal pain have appendicitis (4.7%) highlighting the importance and need to see a senior paediatrician prior to surgical review. The paediatric appendicitis score is an effective and accurate diagnostic tool when used with clinical knowledge. The increased rate of perforations indicate how the pandemic resulted in delayed presentations. Higher negative appendicectomy rates occurred when the pathway was not followed. PAS needs to be added to clerking booklets and calculated for every child with suspected appendicitis. Development of the pathway focus on adolescent females, adapting the score to differentiate tubo-ovarian pathologies and interpreting PAS sore with clinical relevance when assessing septic children.
Analysis of the children’s abdominal pain pathway pre and during COVID and implementation of the paediatric appendicitis score (PAS) in the Mid-Yorkshire Trust