Abstract
BackgroundTo determined the accuracy of ultrasound in diagnosis of acute appendicitis in children keeping histopathology as gold standard.MethodsA prospective evaluations of all ultrasound for appendicitis from January 1, 2014, to June 15, 2017, was conducted at our hospital. A diagnostic protocol was implemented to reduce radiation exposure employing US as the initial imaging modality followed by CT for non-diagnostic US studies in patients with an equivocal clinical presentation. The imaging, operative findings, and pathology of 223 patients (females 80, males 143, age less than 14years) with diagnosed appendicitis were collected. The sensitivity, specificity, predictive value, and negative appendectomy rate were also analyzed. All those patients which had subjected to surgery were included to evaluate the true result of ultrasound in diagnosis of appendicitis.ResultsOf the 223 pediatric appendectomies performed in this time period, a total of 192 (86%) were diagnosed by ultrasound. The histopathology of 8 was normal (3.6%), CT done in 11 and three was normal. The negative appendectomy rate was 3.6%. US were the sole imaging modality in all patients.ConclusionsIn the diagnosis of acute appendicitis in children, ultrasound is useful and accurate mode, which results in a significant decrease in negative appendectomies with no increase in the number of CT scans. This has important implications in the reduction of childhood radiation exposure.Study designcross sectional validation.
Highlights
Zero radiation to children, quick, more efficient and easy excess make ultrasound one of leading choice of diagnosis in appendicitis as compared to computed tomography (CT) or MRI [1]
Ultrasound is regarded, by the American College of Radiology (ACR), as the method best suited for initially imaging a patient with suspected acute appendicitis [5]
In 2010, the Dutch Society of Surgeons introduced guidelines that recommended the routine use of ultrasound and/or computed tomography (CT) for the diagnosis of acute appendicitis [6]
Summary
Quick, more efficient and easy excess make ultrasound one of leading choice of diagnosis in appendicitis as compared to CT or MRI [1]. A diagnostic protocol was implemented to reduce radiation exposure employing US as the initial imaging modality followed by CT for non-diagnostic US studies in patients with an equivocal clinical presentation. The sensitivity, specificity, predictive value, and negative appendectomy rate were analyzed All those patients which had subjected to surgery were included to evaluate the true result of ultrasound in diagnosis of appendicitis. Conclusions: In the diagnosis of acute appendicitis in children, ultrasound is useful and accurate mode, which results in a significant decrease in negative appendectomies with no increase in the number of CT scans. This has important implications in the reduction of childhood radiation exposure.
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