Related Experiment Video
Updated: Mar 10, 2026
Application of Laparoscopic Ultrasonography in Primary Choledochal Suture during Combined Two-lens Surgery
Published on: March 28, 2025
Improving ultrasound for appendicitis through standardized reporting of secondary signs
Kristin N Partain1, Adarsh U Patel1, Curtis Travers2
1Division of Pediatric Surgery, Department of Surgery, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Objective:
Our aim was to implement a standardized US report that included secondary signs of appendicitis (SS) to facilitate accurate diagnosis of appendicitis and decrease the use of computed tomography (CT) and admissions for observation.
Methods:
A multidisciplinary team implemented a quality improvement (QI) intervention in the form of a standardized US report and provided stakeholders with monthly feedback. Outcomes including report compliance, CT use, and observation admissions were compared pretemplate and posttemplate.
Results:
We identified 387 patients in the pretemplate period and 483 patients in the posttemplate period. In the posttemplate period, the reporting of SS increased from 5.4% to 79.5% (p<0.001). Despite lower rates of appendix visualization (43.9% to 32.7%, p<0.001) with US, overall CT use (8.5% vs 7.0%, p=0.41) and the negative appendectomy rate remained stable (1.0% vs 1.0%, p=1.0). CT utilization for patients with an equivocal ultrasound and SS present decreased (36.4% vs 8.9%, p=0.002) and admissions for observations decreased (21.5% vs 15.3%, p=0.02). Test characteristics of RLQ US for appendicitis also improved in the posttemplate period.
Conclusion:
A focused QI initiative led to high compliance rates of utilizing the standardized US report and resulted in lower CT use and fewer admissions for observation. Study of a Diagnostic Test Level of Evidence: 1.
More Related Videos
07:12Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
Published on: September 8, 2023
05:50Author Spotlight: Point-of-Care Ultrasound for Gastric Content Assessment and Risk Stratification in Perioperative Care
Published on: September 22, 2023
Related Concept Videos
01:29Appendicitis-II: Diagnostic Studies and Management
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...
01:22Appendicitis-I: Introduction
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...
01:25Ultrasound II: Endoscopic Ultrasound and FibroScan
Endoscopic Ultrasound (EUS):
01:17Ultrasonography
During an ultrasonography procedure, a handheld device called...
01:24Imaging Studies II: Ultrasonography
01:20Ultrasound I: Abdominal Ultrasonography
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.
The abdominal ultrasound process begins with applying a special gel to the patient's skin over the abdomen. This gel enhances the...