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When appendicitis is suspected in children.

C J Sivit1, M J Siegel, K E Applegate

  • 1Department of Radiology, Rainbow Babies and Children's Hospital of the University Hospitals of Cleveland and Case Western Reserve School of Medicine, 11100 Euclid Ave, Cleveland, OH 44106-5056, USA. sivit@uhrad.com

Radiographics : a Review Publication of the Radiological Society of North America, Inc
|February 7, 2001
PubMed
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Diagnosing acute appendicitis in children can be challenging due to atypical presentations. Imaging like ultrasound and CT scans are crucial for accurate diagnosis and preventing serious complications.

Area of Science:

  • Pediatric Surgery
  • Diagnostic Imaging

Background:

  • Acute appendicitis is the most common surgical emergency in children.
  • Delayed diagnosis leads to severe complications like perforation, sepsis, and death.
  • Clinical diagnosis is often difficult due to atypical presentations in about one-third of pediatric cases.

Purpose of the Study:

  • To review the utility of cross-sectional imaging modalities for diagnosing acute appendicitis in children.
  • To compare the advantages and disadvantages of ultrasonography (US) and computed tomography (CT) in pediatric appendicitis evaluation.

Main Methods:

  • Review of existing literature on ultrasonography and computed tomography for pediatric appendicitis.
  • Analysis of diagnostic accuracy, cost, radiation exposure, and operator dependency of US and CT.

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Main Results:

  • Both ultrasonography (US) and computed tomography (CT) are valuable for evaluating suspected acute appendicitis in children.
  • US offers advantages such as lower cost, no ionizing radiation, and dynamic assessment.
  • CT provides higher diagnostic accuracy, is less operator-dependent, and better delineates disease extent in perforated cases.

Conclusions:

  • Imaging plays a critical role in the timely and accurate diagnosis of acute appendicitis in pediatric patients.
  • The choice between US and CT depends on clinical context, institutional resources, and specific diagnostic needs.
  • Optimizing the use of these imaging modalities is essential to reduce delayed diagnoses and associated morbidity in children.