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Follow-up ultrasonographic findings among children treated conservatively for uncomplicated acute appendicitis

Rodica Stackievicz1,2, Rotem Milner3, Myriam Werner3,4

  • 1Department of Radiology, Meir Medical Center, 59 Tchernichovsky St., Kfar Saba, 4428164, Israel. rodicastac@gmail.com.

Pediatric Radiology
|September 16, 2022
PubMed

Insights

Follow-up ultrasound in children treated for acute appendicitis shows that persistent appendiceal diameter and intraluminal fluid can predict recurrence. These sonographic findings help monitor recovery and identify children at risk for recurrent appendicitis.

Area of Science:

  • Pediatric Radiology
  • Gastrointestinal Imaging
  • Surgical Outcomes

Background:

  • Ultrasound is a reliable diagnostic tool for acute appendicitis.
  • Conservative management of uncomplicated acute appendicitis is safe in children.
  • Sonographic follow-up data for nonoperatively managed pediatric appendicitis are limited.

Purpose of the Study:

  • To characterize the sonographic appearance of the appendix during follow-up after conservative treatment for acute appendicitis in children.
  • To identify ultrasound markers that may predict recurrent acute appendicitis.

Main Methods:

  • Retrospective study of children with uncomplicated acute appendicitis treated conservatively (2014-2019).
  • Follow-up ultrasounds performed at 3, 6, and 9 months post-treatment.
  • Clinical, laboratory, and ultrasound data were collected and analyzed.

Main Results:

  • Recurrent appendicitis developed in 14.2% of 204 children.
  • Appendiceal diameter > 6 mm and intraluminal fluid/sludge at 3- and 6-month follow-up were significantly associated with recurrence (P < 0.001).
  • Progressive normalization of appendiceal diameter was observed in most children.

Conclusions:

  • Follow-up ultrasound is valuable for monitoring children with conservatively treated acute appendicitis.
  • Persistent appendiceal dilation and intraluminal abnormalities on ultrasound may predict recurrent appendicitis.
  • Ultrasound can aid in predicting recurrence risk in pediatric appendicitis cases managed nonoperatively.
Abstract

Keywords:
Acute appendicitisAppendixChildrenConservative treatmentFollow-upRecurrenceUltrasound

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