Abstract
BACKGROUND Acute appendicitis is one of the most common surgical emergency condition in pediatric age group that need admission to pediatric surgery unit for emergent operation of appendectomy . Any delayed in the diagnosis and operation lead to very serious outcome ,including perforation , abscess formation and appendiceal mass formation and other complications which may lead to high mortality and morbidity rate in case of absence timely performed operation of appendectomy . Ultrasound (USG)is one of the most helpful and informative tool in diagnosis of acute appendicitis in children.it is simple , fast , available and with less complications of ionizing radiation that may associated with other modality of radiological methods , like CT . Aims of the study Evaluate the role of USG examination in :- 1-diagnosis of children with suspected appendicitis 2-defining the sensitivity , specificity and the accuracy rate of acute appendicitis in pediatric age group. 3-Decreasing the normal appendectomy in pediatric age group/. patients and method This prospective study has been achieved in the central child teaching hospital in Baghdad during the period from February 2015 to December 2015, that enrolled 110 patients that were admitted pediatric surgery Center in Central Child Hospital in Baghdad who were complained from right lower abdominal pain and acute appendicitis was highly suspected at time of examination .USG examination had been done to these patients. Result Clinical presentation and USG criteria of acute appendicitis had been found in 57 cases out of 110 patients , and those underwent appendectomy operation in the Central Child Teaching Hospital in Baghdad . Unvisualization of appendix or normal ultrasonography criteria had been found in 53 patients. 6 patients out of the those of 53 patients with negative USG finding underwent appendectomy operation due to persistence of clinical finding, 3 of them were with normal appendix while the 3 others were with inflamed appendix according to histopathological examination. The other 47 patients from 53 cases who were complain from right lower abdominal pain, but with negative USG findings , kept for observation for 24 hours and then discharged home with follow up these cases by clinical examination and USG once weekly for 2 weeks. The overall result of a study is as follow :- Specificity = 100% Sensitivity = 95% Accuracy rate =97.27% Positive predictive value =100% negative predictive value = 50% conclusion ultrasonographic examination have effective role in diagnosis of acute appendicitis in pediatric age group. Keywords : Acute appendicitis , ultrasonogaphy in acute appendicitis , sensitivity , specificity , accuracy rate. DOI: 10.7176/JHMN/73-06 Publication date: April 30 th 2020
Highlights
Acute appendicitis is the most common condition that necessitates acute abdominal surgery in children.[1].It is acute inflammation and infection of the vermiform appendix, which is most commonly referred to as the appendix
A total number of 110 patients with age range from 3 years to 15 years old were included in the present study .Clinical diagnosis of acute appendicitis had been done based on symptom of pain on the right lower quadrant of abdomen, nausea,vomiting and with other signs of peritoneal irritation including tenderness, rebound tenderness,cough sign and others
All the patients in present study were kept in the hospital for 24-48 hours with repeated clinical examination in order to prove the diagnosis of acute appendicitis or to exclude it
Summary
Acute appendicitis is the most common condition that necessitates acute abdominal surgery in children.[1].It is acute inflammation and infection of the vermiform appendix, which is most commonly referred to as the appendix. Www.iiste.org common causes of abdominal pain and is the most frequent condition leading to emergent abdominal surgery in children. The appendix may be involved in other infectious, inflammatory, or chronic processes that can lead to appendectomy [2]. Due to atypical clinical presentation of acute appendicitis, the diagnosis is difficult and may be delayed. The majority of children with acute abdominal pain, have self-limited disease that does not necessitate surgery [4]. Delay in diagnosis lead to increased morbidity and mortality and risk of malpractice litigation [9,10]. 2. Defining the sensitivity, specificity and the accuracy rate of acute appendicitis in pediatric age group
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