Selective use of ultrasonography for acute appendicitis in children.
Publication/Presentation Date
3-1-1999
Abstract
BACKGROUND: To evaluate the role of ultrasonography in children with equivocal signs of acute appendicitis, and correlate with initial clinical impression and pathological findings.
METHODS: This is a prospective evaluation of all children presenting with a possible diagnosis of appendicitis during a 14-month study period. Patients with unequivocal clinical signs of appendicitis underwent appendectomy without ultrasonography. Patients with equivocal signs had documentation of the clinical impression and subsequent abdominal ultrasound. Statistical analysis of results was performed using the chi-square test (P
RESULTS: Two hundred fifteen consecutive children were enrolled. Signs were unequivocal in 116 and equivocal in 99. Seven patients in the first group had a normal appendix at operation. Of the 99 patients with equivocal signs, there were 28 true positives, 3 false positives, 64 true negatives, and 4 false negatives. In equivocal cases, sensitivity of the initial clinical impression versus ultrasound was 50% and 88%, respectively (P
CONCLUSIONS: The low false positive rate (6%) in clinically obvious cases of appendicitis does not, in our opinion, warrant ultrasonography. In clinically equivocal cases, ultrasonography is a fast, sensitive, and specific diagnostic modality to diagnose or rule out appendicitis, avoiding the need for prolonged observation and/or hospitalization.
Volume
177
Issue
3
First Page
193
Last Page
196
ISSN
0002-9610
Published In/Presented At
Lessin, M. S., Chan, M., Catallozzi, M., Gilchrist, M. F., Richards, C., Manera, L., Wallach, M. T., & Luks, F. I. (1999). Selective use of ultrasonography for acute appendicitis in children. American journal of surgery, 177(3), 193–196. https://doi.org/10.1016/s0002-9610(99)00002-1
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
10219853
Department(s)
Department of Pediatrics, Department of Surgery
Document Type
Article