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Imaging of acute appendicitis: US as the primary imaging modality
J Alberto Hernandez1, Leonard E Swischuk, Carlos A Angel
1Department of Radiology, University of Texas Medical Branch, Galveston, TX 77555, USA. jahernan@utmb.edu
Pediatric Radiology
|January 7, 2005
Summary
Ultrasound (US) effectively triages pediatric patients with suspected appendicitis, reducing unnecessary surgeries. This noninvasive imaging approach, supported by CT when needed, ensures accurate diagnosis and minimizes radiation exposure.
Area of Science:
- Pediatric Radiology
- Abdominal Imaging
- Emergency Medicine
Background:
- The diagnosis of acute abdomen in children has advanced significantly.
- Imaging plays a crucial role in evaluating right lower quadrant pain.
- Ultrasound (US) and CT scans show comparable accuracy for appendicitis, though consensus varies.
Purpose of the Study:
- To assess the effectiveness of using ultrasound (US) as the primary imaging method for triaging pediatric patients with symptoms suggestive of appendicitis.
Main Methods:
- Retrospective review of 622 children presenting with acute abdominal symptoms.
- Documented imaging diagnoses (US, CT, plain films) and surgical outcomes.
- All appendectomies were recorded to ensure no cases were missed.
Main Results:
- Ultrasound (US) demonstrated high diagnostic accuracy for appendicitis.
- The false-positive appendectomy rate was 3%.
- Other diagnoses included mesenteric adenitis-enteritis and non-appendicitis conditions.
Conclusions:
- Ultrasound (US) is a highly accurate primary imaging modality for suspected appendicitis in children.
- Triage with US, supplemented by CT, is beneficial due to its noninvasive nature and lack of ionizing radiation.