Sonographic diagnosis of acute appendicitis in children: a 3‐year retrospective

@article{Reddan2016SonographicDO,
  title={Sonographic diagnosis of acute appendicitis in children: a 3‐year retrospective},
  author={Tristan Reddan and Jonathan Corness and Kerrie Lee Mengersen and Fiona Harden},
  journal={Sonography},
  year={2016},
  volume={3},
  pages={87 - 94}
}
Ultrasound is commonly used as a tool for investigation of acute appendicitis in children. The accuracy of ultrasound in appendicitis depends on the ability to visualise the appendix and the potential contribution from secondary signs. The study was a retrospective analysis of children referred for sonographic investigation of possible acute appendicitis at an Australian tertiary paediatric hospital between January 2008 and December 2010. 
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TLDR
Australasian sonographers’ confidence in visualising the appendix in children was poor, particularly outside predominantly paediatric practice; workplace support for prolonging examinations to improve visualisation was limited; and the sonographic criteria applied in diagnosis did not reflect contemporary literature. Expand
Improving the value of ultrasound in children with suspected appendicitis: a prospective study integrating secondary sonographic signs
TLDR
Engagement of sonographers performing pediatric appendiceal ultrasound through training in the scanning technique and awareness of secondary signs significantly improved the visualization rate and provided more meaningful findings to referrers. Expand
Analysis of the predictive value of clinical and sonographic variables in children with suspected acute appendicitis using decision tree algorithms
TLDR
This work evaluated the predictive value of sonographic and clinical variables in the diagnosis of acute appendicitis in children using decision tree modelling and found no significant differences in the results between boys and girls. Expand
Diagnostic performance of ultrasound to differentiate perforated from non‐perforated paediatric appendicitis: A narrative review
TLDR
The high specificity of ultrasound indicates that it is a useful diagnostic tool to rule out perforatedappendicitis and differentiate it from non‐perforated appendicitis in children. Expand
Bayesian Approach to Predicting Acute Appendicitis Using Ultrasonographic and Clinical Variables in Children
TLDR
This is the first BN model developed for the identification of acute appendicitis incorporating imaging variables and has particular benefit for cases in which variables are missing because prior probabilities are built into corresponding nodes. Expand
The study of serum c-reactive protein and its diagnostic importance in reducing the rate of negative appendectomy
TLDR
CRP should be added along with clinical diagnosis and other laboratory test in diagnosis of acute appendicitis to reduce the rate of negative appendectomy, according to this study. Expand

References

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TLDR
This study compares the use of US in two tertiary paediatric hospitals and how it influenced the management of suspected appendicitis. Expand
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TLDR
Ultrasound (US) examination during graded compression was performed in 60 consecutive patients with clinical signs of acute appendicitis and the inflamed appendix was visualized in 25 (89%) of 28 patients with confirmed appendix. Expand
Ultrasound of paediatric appendicitis and its secondary sonographic signs: providing a more meaningful finding
TLDR
There is evidence that integrating these secondary signs into the final ultrasound diagnosis can improve the utility of ultrasound in cases where appendicitis is expected, though there remains some conjecture about whether they play a more important role in negative or positive prediction in the absence of an identifiable appendix. Expand
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TLDR
Although uncommonly seen, large amounts of free fluid, phlegmon, and pericecal inflammatory fat changes were very specific signs of acute appendicitis. Expand
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TLDR
US followed by selective CT for the diagnosis of acute appendicitis is useful and accurate and has important implications in the reduction of childhood radiation exposure. Expand
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TLDR
An inconclusive result of ultrasound for appendicitis was significantly more frequent in teens than in preteens and carried a high likelihood of appendiciticis; Conversely, a nonvisualized appendix was equally frequent in teenagers andPreteens, and had a low likelihood of appendix infection. Expand
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TLDR
Day-to-day use of US for acute appendicitis does not perform as purported in the literature and involvement by experienced personnel and/or additional training is needed to improve the diagnostic performance. Expand
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TLDR
US should be the initial imaging study of choice for pediatric appendicitis and the accuracy was 96%, was independent of patient and system factors and resulted in reduced follow-up CTs and negative laparotomies. Expand
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TLDR
It is shown that in case of non-visualization of the appendix without secondary signs, appendicitis can be safely ruled out and secondary signs of appendix alone are a strong indicator of acute appendectomy. Expand
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TLDR
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