0210

THE SIGNIFICANCE OF RIGHT HEEL TEST IN DIAGNOSIS OF CHILDREN ACUTE APPENDICITIS

GAO Z-Q, QIU H-H, MA X-J

Shanwei People’s Hospital, Shanwei, China

Objective: To study the significance of right heel test (RHT) in diagnosis of children acute appendicitis.

Methods: (1) RHT：Let the patient lie on his back with his legs both stretched, the doctor lifts the patient’s right ankle up about 20 cm and percusses the patient’s right heel with his right palm. If the above action causes pain in the patient’s right lower abdomen, it will be RHT positive (+), otherwise, it will be RHT negative (-). (2) According to the analyses of 425 cases with acute abdomen that were examined by the way of RHT during the years from 1985 to 2000, 146 cases with sufficient clinical or pathologic data, who were followed up for two weeks, were divided into two groups, clinical control group of 71 cases (40 boys and 31 girls) aged 2-14 years old, and acute appendicitis group of 75 cases (44 boys and 31 girls) aged 2-14 years old.

Results: Of the 71 controls, 4 were RHT positive (+) and 67 were RHT Negative (-); among the 75 acute appendicitis, 46 were RHT positive (+) and 29 were RHT negative (-); RHT positive rates were significantly different between the above two groups (χ²=50.25, P<0.005). In diagnosis of children acute appendicitis, RHT specificity, sensitivity and accuracy were 94.4%, 61.3% and 77.4%, respectively; besides, RHT positive likelihood ratio and Youden’s Index were 10.89and 0.58 respectively.

Conclusion: RHT is of reference value in diagnosis of children acute appendicitis.