Accuracy of Ultrasound in the Evaluation of Pediatric Abdominal Surgical Emergency: A Comparison with Intra-Operative Findings

Abstract

Background: Pediatric abdominal surgery emergency (PASE) is a frequent reason for emergency admission and surgery in children. PASE is a significant cause of morbidity and mortality especially in developing countries and it constitutes a significant workload of the pediatric surgeon. Ultrasound is available, affordable and accessible in most centers. Though ultrasound is operator dependent, its evaluation of children who have abdominal symptom plays a central role in surgical decision making. Methodology: We evaluated the medical records of all the consecutive children who presented with abdominal symptoms, had abdominal ultrasound and were operated upon between October 2017 and March 2019. This study was carried out in a teaching hospital in Enugu, Nigeria. We compared the ultrasound reports and intra-operative findings; and determined the extent of accuracy of the ultrasound report. Results: One hundred and forty seven children were retrospectively analyzed. There was male dominance and abdominal pain was the predominant presenting symptom. The mean age of the patients at presentation was 6 years. All the patients had abdominal ultrasound and the overall accuracy of ultrasound was 65.8%. Intussusception is the disease condition that had the highest level of ultrasound accuracy. Most of the patients (93.2%) did well and were discharged home. There were 10 deaths accounting for 6.8% of the patients. Conclusion: Abdominal ultrasound is reliable and fairly accurate in the evaluation of children who have abdominal disease conditions.