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Multimodality Diagnosis of Mesenteric Ischemia

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Published on: July 21, 2023

Do we need imaging to diagnose appendicitis in children?

Antonio Di Cesare¹, Filippo Parolini, Anna Morandi

¹Department of Pediatric Surgery, Fondazione IRCCS Ca 'Granda-Ospedale Maggiore Policlinico, Milano, Italy.

African Journal of Paediatric Surgery : AJPS

|July 18, 2013

Summary

Clinical assessment is key for diagnosing appendicitis in children. Selective imaging, particularly ultrasonography, can help avoid unnecessary appendectomies in girls over 10.

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Point-of-Care Kidney and Genitourinary Ultrasound in Adults: Image Acquisition

Point-of-Care Kidney and Genitourinary Ultrasound in Adults: Image Acquisition

Published on: June 21, 2024

Area of Science:

Pediatric Surgery
Emergency Medicine
Diagnostic Imaging

Background:

Acute appendicitis is a common surgical emergency in children.
Accurate diagnosis relies heavily on clinical evaluation.
The role of diagnostic imaging in suspected pediatric appendicitis requires careful consideration.

Purpose of the Study:

To evaluate the effectiveness of clinical assessment combined with selective imaging for managing suspected acute appendicitis in pediatric patients.
To determine the impact of imaging strategies on negative appendectomy and complication rates.

Main Methods:

Retrospective review of medical records for children presenting with suspected appendicitis.
Analysis of diagnostic investigations, pathological findings, and surgical outcomes.
Calculation of negative appendectomy and complication rates, stratified by age and sex.

Main Results:

Out of 923 children, 24.3% were admitted for observation; 137 underwent appendectomy.
Most appendectomies (82.4%) were performed without preoperative imaging.
Imaging was used more frequently in non-operated children (39.3%) vs. operated (17.5%).
Complicated appendicitis rate was 26.4%; negative appendectomy rate was 8.8%.
Females over 10 had higher rates of non-confirmed appendicitis (22.2%).

Conclusions:

Clinical assessment remains the cornerstone for diagnosing appendicitis in children.
Selective use of imaging, primarily ultrasonography, is recommended for girls over 10 to reduce unnecessary appendectomies.
Ultrasonography is the preferred imaging modality in equivocal cases.