Latar belakang Apendisitis merupakan kasus paling sering dilakukan pembedahaan pada anak, sampai saat ini masih sering terjadi keterlambatan mendiagnosis apendisitis anak. Insiden cukup tinggi 25 / 10.000 anak per tahun pada usia 10 - 17 tahun. Anak < 5 tahun 85 % datang telah mengalami perforasi, usia < 1 tahun 100% mengalami perforasi , walau pun telah ada penelitian mendiagnosis apendisitis anak seperti PAS, Alvarado score modifikasi namun hasilnya belum memuaskan. Tujuan Mengetahui level diagnosis apendisitis anak yang memerlukan tindakan operasi,sehingga komplikasi apendisitis pada anak dapat di tekan. Metode Penelitian ini menggunakan 76 penderita apendisitis di RSUP Prof DR SARDJITO dari bulan januari 2013 sampai dengan desember 2013 semua penderita usia < 18 tahun yang telah didiagnosis dengan apendisitis anak, data yang di ambil di antaranya : klinis ( anamnesa + pemeriksaan fisik ) , pemeriksaan penunjang , dan imaging dan semua penderita adalah penderita apendisitis yang telah di lakukan operasi dan hasilnya di bandingkan dengan gold standar dengan pemeriksaan histopatologi ( PA), data didesain dengan cross-section dan diolah dengan uji proporsi > 0.5 p dianggap signifikan jika < 0.05. Hasil Dari 76 penderita yang di diagnosis apendisitis anak usia < 18 tahun temuan klinis dan penunjang adalah : mual 57,8 % , muntah 59,2 %, anoreksia 69,7 % , nyeri perut berpindah 57,8 % , nyeri periumbilikal 63,2 % , nyeri perut kanan bawah 97,3%, Mc burney sign 94,7 % , Psoas sign 25,0 %, Obsturator sign 32,9 %, Rovsing sign 14,5%, leukosit > 10.000mm3 75 %, neutrophil > 70 % 72,4 %, CRP > 5 64,4 %, apendicolit 100%, USG 53 %, barium follow through 87,5 %, hasil penelitian di atas beberapa di antaranya signifikan < 0.05. Kesimpulan Semua penderita apendisitis yang telah dilakukan operasi memenuhi kriteria diagnosis level I dn II, dimana kriteria diagnosis level I di harapkan dilakukan operasi segera ( cito), sedangkan kriteria diagnosis level II dapat dilakukan operasi elektif atau interval apendektomi, dan kriteria diagnosis level III dapat dilakukan rawat jalan.

Background Appendicitis is a case that is mostly treated with surgery on children. Late treatment of appendicitis on child occurs often. It causes complication on the appendicitis that lead to increase in morbidity and mortality of child with appendicitis. Appendicitis incident was high (25/10,000) on child of 10-17 year old. Children less than 5 years come with perforation (85%), while more than 1 year children come with 100% perforation. Although there are researches on pediatric appendicitis diagnosis such as PAS and modified Alvarado, their results are not satisfactory. Purpose To identify level diagnosis of pediatric appendicitis requiring operative treatment, so appendicitis complication can be reduced. Method This research used 76 patients with appendicitis in Sardjito hospital from January 2013 to December 2013. All patients were more than 18 years old and diagnosed with appendicitis. Data taken were clinical data (anamnesis and physical examination), supporting examination and imaging. All patients have treated with surgery and the results were compared with gold standard with histopathology examination (PA). This research used cross-section design using proportional test of >0.5 and significant when p<0.05. Result Of 76 patients diagnosed with pediatric appendicitis clinical and supporting findings are as follow: nausea 57.8%, vomit 59.2%, anorexia 69.7%, moving stomachache 57.8%, periumbilical pain 63.2%, lower right stomachache, Mc Burney sign 94.7%, Psoas sign 25.0%, obturator sign 32.9%, Rovsing sign 14.5%, leukocyte >10,000mm neutrophil >70% 72.4%, CRP>5 64.4%, appendicolith 100%, USG 53%, and barium follow through 87.5%. some results above are significant (<0.05). Conclusion All patients with appendicitis treated with surgery have level I and level II diagnosis criteria. Where level I diagnosis criteria require immediate operation (cito), while level II diagnosis require elective operation or interval appendectomy, and level II diagnosis may obtain outpatient care.

Kata Kunci : Level diagnosis, kriteria mayor dan minor, apendisitis anak