Cost-effectiveness of sonographic diagnosis of appendicitis in children.

Abstract

diagnosis of appendicitis in children be difficult, and a clipical may significant number of patients have a normal appendix at laparotomy. Gastroente~'itis, lymphadenitis, or other inflammatory disease may simulate appendicitis. Since 1986, when Puylaert [1] described using sonogmphy as the initial imaging technique in acute appendicitis, abdominal sonography has gained in popularity for this indication. The characteristic finding at sonography is an edematous, noncompressible appendix larger than 6 mm in diameter, often surrounded by fluid. The sensitivity of sonography for acute appendicitis is reported to be in the range of 80--95%, and specificity is 89100~ [2-4]. An abscess is usually detected with sonography, but computed tomography (CT) scanning is generally superior in differentiating nondrainable abscess from a phlegmon. Visualization of a normal appendix by sonography excludes appendicitis. Frequently, large lymph nodes are detected. A thorough evaluation of the cost-effectiveness of abdominal sonography in children with suspected appendicitis is not yet available. However, cost-consciousness has made such information essential [5], so we undertook this study to provide preliminary comparative data.