[Evaluation of redundancy of tests in acute appendicitis]

Evaluation of the redundancy of abdominal ultrasound tests in the diagnosis of acute appendicitis in a third level hospital.

Retrospective study of patients treated for suspected acute appendicitis in 2011 at our center. The variables of the study were: age, origin of the patient, blood count, number of ultrasounds performed, surgery and final diagnosis based on surgical findings. We defined as redundant ultrasound the request for a new ultrasound in patients with a final diagnosis of appendicitis and previous positive ultrasound.nd total expressed as percentage of observed / expected lung volume (VPT o/e) and percentage of herniated liver (PHH). We studied: survival, ECMO and associated malformations.

340 patients with a mean age of 9.4 years (range 2-13) were analyzed, 278 of whom had appendicitis and 62 non-specific abdominal pain. 246 were derived from other centers of which 217 (88%) provided an ultrasound. Of the 198 patients referred with positive ultrasound, 76 cases were repeated, of which 78.9% can be considered as redundant. From the total of patients with appendicitis, 29.6% were operated on with 2 or more ultrasounds. Leukocytosis was not found to influence ultrasound redundancy (15,600 vs 15,100, p > 0.05).

The 78.9% of the duplicate ultrasounds do not fit the definition of rational use of a diagnostic test. The greater request for ultrasound is not attributable to differences on the blood test results, nevertheless the origin of the patient seems to influence in that request.