Ultrasonography of non-perforated appendicitis in young children

The role of ultrasonography in diagnosing non-perforated appendicitis in young children is reviewed.

Between January 1997 and September 1999, three children with abdominal pain due to non-perforated appendicitis were admitted to the Nippon Medical School Hospital. Ultrasonography of the right lower quadrant was performed using a 7.5-MHz curved array transducer with the graded compression technique.

Edema of the appendix was detected in all cases. The appendiceal diameter was 9 to 18 mm, and the thickness of the muscular wall was 3.5 to 6 mm. An echogenic submucosal layer, increased periappendiceal echogenicity, and the acoustic shadow of the proximal appendix was detected in each case. Localized fluid collection was not observed in any patient. Surgical and histopathological findings were nonperforated gangrenous appendicitis with fecal stone in all three cases.

Ultrasonography provides valuable clinical information about the ileocecal region in children with acute abdominal pain. Even when the clinical diagnosis seems well established, performing ultrasonography routinely may help reduce the rate of perforation by decreasing the time required to establish the diagnosis.