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Association of Gallbladder Volume and Wall Thickness With Acute Appendicitis in Pediatric Patients
Ahmet Yalcin1, Berrin Demir2, Muhammed Demir3
1From the Department of Radiology, Faculty of Medicine, Erzincan University.
Insights
In pediatric patients, increased gallbladder volume during ultrasonography is linked to appendicitis, while thicker gallbladder walls may indicate its absence. These findings aid in diagnosing appendicitis when the appendix is not clearly visualized.
Area of Science:
- Pediatric Radiology
- Abdominal Imaging
- Gastrointestinal Diagnostics
Background:
- Ultrasonography is key for diagnosing appendicitis in children.
- Secondary ultrasound findings are crucial when the appendix is not visualized.
- Evaluating adjacent organs like the gallbladder can provide diagnostic clues.
Purpose of the Study:
- To assess gallbladder wall thickness and volume in pediatric patients with suspected appendicitis.
- To determine if gallbladder parameters correlate with appendicitis diagnosis.
- To explore the utility of gallbladder measurements as secondary ultrasound markers.
Main Methods:
- A prospective study included 113 pediatric patients with suspected appendicitis.
- Radiologists measured gallbladder wall thickness, width, length, and height.
- Appendix assessment was categorized as acute appendicitis, normal, or equivocal.
- Statistical analysis sought associations between gallbladder metrics and appendicitis.
Main Results:
- Gallbladder wall thickness was significantly higher in patients without appendicitis (P=0.017).
- Gallbladder volume was significantly increased in patients with appendicitis (P=0.004).
- Receiver operating characteristic analysis identified thresholds for gallbladder wall thickness (0.5 mm) and volume (41.6 mL) with high sensitivity and specificity.
Conclusions:
- Gallbladder wall thickness and volume are associated with appendicitis diagnosis in pediatric patients.
- These gallbladder measurements can serve as valuable secondary indicators in appendicitis diagnosis via ultrasound.
Objectives:
Ultrasonography in a child with suspected appendicitis is primarily performed to detect inflamed appendix, whereas secondary findings are important in patients with a nonvisualized appendix. The aim of this study is to evaluate the gallbladder wall thickness and volume in patients with suspected appendicitis and search an association between these parameters and appendicitis.
Methods:
Between January 2018 and August 2018, 113 patients with suspected appendicitis were included in this prospective study. Gallbladder and right lower quadrant were evaluated in separate sessions by different radiologists. The wall thickness along with the width, length, and height of the gallbladder was measured and recorded for each patient. Assessment of the appendix was classified as acute appendicitis, normal, and equivocal. Statistically significant association was sought between the thickness of the gallbladder wall and diagnosis of appendicitis.
Results:
Gallbladder wall thickness was significantly higher in patients without appendicitis (P = 0.017), whereas significantly increased gallbladder volume was observed in patients with appendicitis (P = 0.004). Receiver operating characteristic analysis showed gallbladder wall thickness threshold of 0.5 mm with a sensitivity of 83.3, specificity of 93.9, and volume threshold of 41.6 mL with a sensitivity of 100 and a specificity of 0.69.
Conclusions:
Gallbladder wall thickness and volume measurements were associated with the diagnosis of appendicitis in pediatric patients.
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