Clinical validity of ultrasound in children with suspected appendicitis.
OBJECTIVE
To determine the accuracy of diagnosing appendicitis in the pediatric population by using graded compression ultrasonography.


METHODS
Retrospective case review.


METHODS
University-affiliated community hospital with an emergency department census of approximately 19,000 pediatric visits per year.


METHODS
Ninety-eight children (age less than 13 years) with clinically suspected appendicitis who had graded compression sonographic studies during the 24-month study period.


METHODS
Medical records were reviewed for patient demographics, presenting signs and symptoms, sonographic findings, surgical results, and hospital course. Patients who did not undergo surgery were followed up by telephone for a minimum of two months.


RESULTS
Ninety-eight children (42 boys and 56 girls; age range, 2 to 12 years; mean age, 8.0 years) with clinical signs and symptoms of acute appendicitis were examined sonographically. Of the 26 patients whose appendicitis was verified at surgery, ultrasound was positive in 22, with an overall sensitivity of 85%. Of the 72 patients who did not have appendicitis, ultrasound was negative in 68, with a specificity of 94%. Two patients with false-positive ultrasound went to surgery and were found to have acute ileitis and perforated Meckel's diverticulum. The overall diagnostic accuracy was 91.8% (90 of 98).


CONCLUSIONS
Use of ultrasound to diagnose acute appendicitis was performed with a sensitivity of 85% and a specificity of 94%. This allows the same accuracy in children as has been reported with adults.
Emergency Medicine Residency Program, Butterworth Hospital, Grand Rapids.
S K
SK
Crady
J S
JS
Jones
T
T
Wyn
C R
CR
Luttenton
D000208:Acute Disease; D001064:Appendicitis / Q000000981:diagnostic imaging*; D001065:Appendix / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography