Abstract
This study systematically examines pediatric adnexal torsion, proposing a diagnostic approach using machine learning techniques to distinguish it from acute appendicitis. Our retrospective analysis involved 41 female pediatric patients divided into two groups: 21 with adnexal torsion (group 1) and 20 with acute appendicitis (group 2). In group 1, the average age was 10 ± 2.6 years, while in group 2, it was 9.8 ± 21.9 years. Our analysis found no statistically significant age distinctions between these two groups. Despite acute lower abdominal pain being a common factor, group 1 displayed shorter pain duration (28.9 h vs. 46.8 h, p < 0.05), less vomiting (28% vs. 50%, p < 0.05), lower fever incidence (4.7% vs. 50%, p < 0.05), reduced leukocytosis (57% vs. 75%, p < 0.05), and CRP elevation (30% vs. 80%, p < 0.05) compared to group 2. Machine learning techniques, specifically support vector classifiers, were employed using clinical presentation, pain duration, white blood cell counts, and ultrasound findings as features. The classifier consistently demonstrated an average predictive accuracy of 87% to 97% in distinguishing adnexal torsion from appendicitis, as confirmed across various SVM models employing different kernels. Our findings emphasize the capacity of support vector machines (SVMs) and machine learning as a whole to augment diagnostic accuracy when distinguishing between adnexal torsion and acute appendicitis. Nevertheless, it is imperative to validate these results through more extensive investigations and explore alternative machine learning models for a comprehensive understanding of their diagnostic capabilities.