Does the use of ultrasonography improve the outcome of children with appendicitis?
OBJECTIVE
To determine whether the use of ultrasonography (US) improves the outcome of children with appendicitis.


METHODS
All cases of patients (<17 years old) with pathologically confirmed appendicitis treated in the ED between July 1992 and December 1995 were retrospectively reviewed.


RESULTS
231 charts met criteria for analysis. 100 (43%) patients had US prior to surgery. Age, race, and insurance status were similar for children in the US and non-US groups; there were no differences between the groups at presentation in mean temperature, mean WBC count, or percentage of children with vomiting, diarrhea, abdominal tenderness, or guarding. Those in the non-US group were more often male (71%, p=0.002) and more frequently had right lower quadrant pain (65%, p=0.003). Time from ED triage to the OR was 17.1 hours (US group) vs 10.4 hours (non-US group) (p=0.002). The perforation rates and the complication (abscess, wound infection, wound dehiscence) rates were similar for children in the two groups. Hospital charges were higher in the US group than in the non-US group ($14,123 vs $13,021, p=0.007).


CONCLUSIONS
The use of US did not result in early diagnosis of appendicitis, nor was it associated with a reduction in perforation or complication rates. Among children with clinical evidence of appendicitis, US was associated with a delay in surgery and an increase in hospital charges.
Roosevelt
G E
GE
Department of Pediatrics, Northwestern University Medical School, Chicago, IL, USA. geroos@nwu.edu
Reynolds
S L
SL
D001064:Appendicitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000191:economics; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D004636:Emergency Service, Hospital / Q000191:economics; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies; D014463:Ultrasonography; D014481:United States