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Sonography of ruptured appendicitis.

C E Blane, S J White, J R Wesley

    Gastrointestinal Radiology
    |January 1, 1986
    PubMed
    Summary
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    Ultrasound can help diagnose ruptured appendicitis in children. This study found specific sonographic features of abscesses, though technically challenging due to ileus.

    Area of Science:

    • Pediatric Radiology
    • Abdominal Imaging
    • Emergency Medicine

    Background:

    • Appendicitis is a common surgical emergency in children.
    • Ruptured appendicitis can lead to abscess formation, complicating diagnosis and management.
    • Sonography is frequently used for evaluating pediatric abdominal pain.

    Purpose of the Study:

    • To describe the sonographic findings in children with ruptured appendicitis.
    • To evaluate the utility of ultrasound in diagnosing and monitoring appendiceal abscesses.
    • To highlight technical challenges in sonographic evaluation of ruptured appendicitis.

    Main Methods:

    • Retrospective review of 19 sonographic studies (5 pre-treatment, 14 follow-up) in 7 children with ruptured appendicitis.
    • Analysis of sonographic characteristics of identified abscesses.

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  • Assessment of technical difficulties encountered during sonography.

    • Main Results:

    • Four pre-treatment and two post-operative abscesses were identified.
    • Abscesses were typically ovoid with irregular margins and low-amplitude internal echoes.
    • Gastrointestinal ileus presented a significant technical challenge.
    • Follow-up studies revealed distant fluid collections, and one antibiotic-treated patient showed complete abscess resolution sonographically.

    Conclusions:

    • Ultrasound is valuable for diagnosing ruptured appendicitis in children.
    • Specific sonographic features can suggest appendiceal abscesses.
    • Careful attention to detail is crucial due to potential technical difficulties, especially with ileus.