Routine ultrasound for suspected appendicitis in children: a single-centre retrospective cohort study

Area of Science:

• Pediatric Surgery
• Diagnostic Imaging
• Emergency Medicine

Background:

• Appendicitis is a common pediatric surgical emergency with diagnostic challenges.
• Diagnostic imaging, particularly ultrasound, is increasingly used to improve accuracy and reduce negative appendicectomy rates.
• This study evaluates the implementation of routine ultrasound for suspected appendicitis in children.

Purpose of the Study:

• To assess the effectiveness of routine ultrasound in diagnosing appendicitis in children.
• To determine the accuracy (sensitivity and specificity) of ultrasound for appendicitis.
• To evaluate the impact of routine ultrasound on negative appendicectomy rates and patient outcomes.

Main Methods:

• A retrospective cohort study of children aged 5-16 years with suspected appendicitis.
• Data collected on ultrasound use, diagnostic accuracy, negative appendicectomy rate, treatment, length of stay, and complications.
• Analysis of outcomes over a 12-month period.

Main Results:

• Ultrasound was used in 87.5% of 193 children with suspected appendicitis.
• Ultrasound demonstrated high sensitivity (90%) and specificity (100%) for diagnosing appendicitis.
• The negative appendicectomy rate was very low at 1.4%, with laparoscopic appendicectomy being the primary surgical approach.

Conclusions:

• Routine ultrasound is a highly sensitive and specific tool for diagnosing appendicitis in children.
• Implementing routine ultrasound significantly lowers the negative appendicectomy rate.
• This practice change represents a major advancement for pediatric surgical units.