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Related Concept Videos

Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

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Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
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Ultrasonography01:17

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Ultrasonography is an imaging technique that uses high-frequency sound waves to visualize the body's internal structures. It is a non-invasive and safe procedure that does not involve the use of ionizing radiation, making it widely used in various medical fields. Ultrasonography is used to study heart function, blood flow in the neck or extremities, certain conditions such as gallbladder disease, and fetal growth and development.
During an ultrasonography procedure, a handheld device called...
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Appendicitis-I: Introduction01:22

Appendicitis-I: Introduction

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The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
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Imaging Studies II: Ultrasonography01:24

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IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
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Appendicitis01:19

Appendicitis

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Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
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Ultrasound I: Abdominal Ultrasonography01:20

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Introduction:
Abdominal ultrasonography, commonly known as abdominal ultrasound, is a vital, non-invasive medical imaging technique widely used in healthcare.
Procedure:
This diagnostic tool allows the clinician to visually inspect internal structures within the abdomen, including vital organs such as the liver, gallbladder, pancreas, kidneys, and spleen.
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Application of Laparoscopic Ultrasonography in Primary Choledochal Suture during Combined Two-lens Surgery
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When does ultrasonography influence management in suspected appendicitis?

Duncan S G Scrimgeour1, Christopher P Driver, Rebecca S Stoner

  • 1Department of Surgical Paediatrics, Royal Aberdeen Children's Hospital, Aberdeen, Scotland, UK.

ANZ Journal of Surgery
|January 11, 2014
PubMed
Summary

Ultrasonography (US) can accurately rule out appendicitis in children when a normal appendix is visualized. However, positive US findings require clinical correlation for surgical decisions, and improved visualization rates could reduce unnecessary surgeries.

Keywords:
appendicectomyappendicitischilddiagnosisultrasonography

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Area of Science:

  • Pediatric Surgery
  • Diagnostic Imaging
  • Gastroenterology

Background:

  • Accurate diagnosis of appendicitis in children remains a clinical challenge.
  • The role of ultrasonography (US) in diagnosing appendicitis and guiding management is debated.
  • This study compares US utilization and its impact on appendicitis management in two tertiary pediatric hospitals.

Purpose of the Study:

  • To compare the use of ultrasonography (US) in diagnosing appendicitis across two pediatric tertiary hospitals.
  • To evaluate how US influences the management decisions for suspected appendicitis in children.
  • To assess the diagnostic accuracy and impact of US on surgical outcomes for appendicitis.

Main Methods:

  • A cross-referenced data review of acute admissions, radiology, histopathology, and surgical records.
  • Inclusion of all children undergoing appendicectomy for suspected appendicitis in Christchurch, New Zealand, and Aberdeen, Scotland, during 2009.
  • Comparison of appendicectomy outcomes based on preoperative US findings and appendix visualization rates.

Main Results:

  • 599 children were included; US was performed in 23% with a 29% overall visualization rate.
  • The positive and negative predictive values for US were 67% and 100%, respectively.
  • Visualization of a normal appendix on US accurately excluded appendicitis, while higher visualization rates correlated with fewer non-inflamed appendix removals.

Conclusions:

  • A normal appendix visualized on US provides high confidence in excluding appendicitis.
  • Positive US findings for appendicitis should be interpreted alongside clinical presentation to guide surgical decisions.
  • Increasing the rate of appendiceal visualization by sonographers can potentially reduce the incidence of non-inflamed appendix surgeries.