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The radiological signs of acute appendicitis in infancy and childhood
Insights
Radiographs can help diagnose acute appendicitis in children. Key signs include scoliosis, properitoneal line displacement, and bowel dilatation, aiding diagnosis, especially in young children.
Area of Science:
- Pediatric Radiology
- Gastrointestinal Imaging
- Surgical Pediatrics
Background:
- Acute appendicitis is a common surgical emergency in children.
- Diagnostic challenges exist, particularly in younger children.
- Radiological imaging plays a role in preoperative assessment.
Purpose of the Study:
- To retrospectively review radiological findings in children with acute appendicitis.
- To identify specific radiographic signs associated with acute appendicitis.
- To evaluate the utility of radiology in diagnosing appendicitis, especially in young children.
Main Methods:
- Retrospective review of pre-operative radiographs from 93 children who underwent surgery for suspected appendicitis.
- Comparison with radiographs from 40 children with abdominal pain but no appendicitis.
- Analysis of specific radiological findings such as scoliosis, properitoneal line displacement, and bowel dilatation.
Main Results:
- Acute appendicitis was confirmed in 76% of operated children.
- Children with appendicitis showed a higher incidence of scoliosis, properitoneal line displacement, caecal dilatation, and terminal ileal dilatation with air/fluid levels.
- Radiologically demonstrable fecaliths were not significantly more frequent in appendicitis cases.
Conclusions:
- Specific radiological findings on pre-operative radiographs are helpful in diagnosing acute appendicitis in children.
- These signs are particularly valuable in children under 4 years old, where clinical diagnosis is often difficult.
- Radiology can aid in differentiating appendicitis from other causes of abdominal pain in pediatric patients.
Abstract:
The radiological findings in 93 children operated on for acute appendicitis were reviewed retrospectively; acute appendicitis was confirmed in 76 (81%). These children were compared with 40 children with abdominal pain, but without appendicitis. Pre-operative radiographs in the children with appendicitis showed a significantly higher incidence of scoliosis, properitoneal line displacement, caecal dilatation with air/fluid levels and terminal ileal dilatation with air/fluid levels. The incidence of radiologically demonstrable faecaliths was not statistically higher in the children suffering from acute appendicitis. In children under the age of 4 years, in whom the diagnosis of acute appendicitis is often difficult, the radiological signs are helpful.