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

Abstract

Introduction: 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. Methods: Radiology reports, ultrasound images and electronic medical records were evaluated for eligible patients. The ability to visualise the appendix and determine secondary sonographic signs was evaluated for diagnostic accuracy. Results: The study identified 457 eligible children, with the appendix visualised on ultrasound in 40.7% of cases. Using a binary diagnostic model that incorporated equivocal results, sensitivity of ultrasound to diagnose acute appendicitis was 88.1%, specificity 91.4% and accuracy 90.4%. Ultrasound was found to have a high negative predictive value (96.3%), and the presence of echogenic mesentery had a positive predictive value of 89.4%. Discussion: Our results compare favourably with other studies, but indicate the potential for improvement in accuracy and visualisation, with a future study incorporating new methods of categorising ultrasound findings currently being undertaken.L6111821622016-07-18 <br />2016-09-16 <br />