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Diagnostic Ultrasound for Acute Appendicitis: The Gold Standard
Kiera Roberts1, Hamish Moore1, Mahima Raju2
1Department of Paediatric Surgery, Women's and Children's Hospital, Adelaide, SA, Australia.
Journal of Pediatric Surgery
|November 20, 2023
Summary
Ultrasound is highly accurate for diagnosing appendicitis in children, achieving 96.1% overall accuracy. This imaging modality effectively reduces negative appendicectomy rates, establishing it as a preferred first-line diagnostic tool.
Area of Science:
- Pediatric Radiology
- Diagnostic Imaging
- Surgical Pathology
Background:
- Acute appendicitis diagnosis in children can be challenging.
- Ultrasound is a key imaging modality for evaluating suspected appendicitis.
Purpose of the Study:
- To review the diagnostic accuracy of ultrasound for acute appendicitis in pediatric patients.
- To assess the impact of ultrasound on negative appendicectomy rates.
Main Methods:
- Retrospective review of ultrasound studies for appendicitis from 2015-2021.
- Analysis of medical records for operative intervention, further imaging, and final diagnosis.
- Calculation of diagnostic accuracy metrics including sensitivity, specificity, and predictive values.
Main Results:
- Overall diagnostic accuracy of ultrasound was 96.1% with a 91.0% visualization rate.
- High sensitivity (96.2%) and specificity (96.1%) were observed.
- The negative appendicectomy rate was reduced to 5.5% in children who underwent pre-operative ultrasound.
Conclusions:
- Ultrasound demonstrates gold-standard accuracy for diagnosing pediatric appendicitis.
- Ultrasound effectively reduces negative appendicectomy rates.
- Ultrasound should be the first-line investigation for acute appendicitis in children.
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