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Diagnosis of appendicitis in the paediatric emergency department: an update

Ben Lawton, Henry Goldstein, Tessa Davis

    Current Opinion in Pediatrics
    |May 16, 2019
    PubMed

    Insights

    Diagnosing appendicitis in children is improving with point-of-care ultrasound and serial examinations. While novel biomarkers and algorithms are explored, current diagnostic accuracy relies on clinical assessment and advanced imaging techniques.

    Area of Science:

    • Pediatric Emergency Medicine
    • Diagnostic Imaging in Children
    • Gastrointestinal Disorders

    Background:

    • Appendicitis is a frequent cause of pediatric emergency department visits.
    • Accurate diagnosis in children is crucial to prevent complications.

    Purpose of the Study:

    • To review advancements in diagnosing pediatric appendicitis.
    • To assess the role of biomarkers, imaging, and clinical scoring systems.

    Main Methods:

    • Review of recent literature on diagnostic tools for appendicitis in children.
    • Analysis of trends in biomarker research, imaging modalities (ultrasound, CT, MRI), and clinical algorithms.

    Main Results:

    • Point-of-care ultrasound use is increasing, reducing reliance on computed tomography (CT).
    • Novel biomarkers and refined clinical algorithms have not yet reached sufficient diagnostic accuracy.
    • Clinician-performed ultrasound and magnetic resonance imaging (MRI) show promise, while basic lab tests are de-emphasized.

    Conclusions:

    • Appendicitis diagnosis remains primarily clinical.
    • Point-of-care ultrasound offers improved accuracy over traditional lab tests.
    • Serial examinations, clinician-performed ultrasound, and MRI are valuable tools, with decreased emphasis on CT and basic laboratory investigations.
    Abstract

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