Ultrasonography in suspected acute appendicitis in childhood-report of 1285 cases.
OBJECTIVE
For the assessment of the diagnostic value of real-time ultrasonography (US) in children with suspected acute appendicitis (a.A.) the results of graded compression US are compared with clinical and histological final diagnoses.


METHODS
In a prospective study over nearly 9 years we examined 1285 children aged 1-15 years (m=514, f=771). Using a 5-MHz curved array transducer the right lower quadrant was examined in a graded compression technique.


RESULTS
Prevalence of histologically proven a.A. was remarkably low (9%). In diagnosis of acute appendicitis in childhood US achieves a sensitivity of 92%, specificity of 98%, a positive predictive value of 90% and a negative predictive value of 98%. The overall accuracy was 98%. Mesenteric lymphadenitis was seen in 181 cases (prevalence 12%) and terminal ileitis occasionally accompanied by mesenteric lymphadenitis was seen in 116 cases (prevalence 9%).


CONCLUSIONS
In children with suspected appendicitis US of the abdomen gives great diagnostical value for differential diagnosis of a.A. and other more frequent inflammatory diseases of the ileocoecal region. Thus US provides further reliable information to the referring physician. Consequently it is necessary to perform US in each child with acute abdominal pain, even if clinical diagnosis seems to be well established.
Schulte
B
B
Department of Diagnostic and Interventional Radiology, Academic Teaching Hospital Cologne-Porz, University of Cologne Medical School, Urbacher Weg 19, Krankenhaus Porz am Rhein, D-51149, Köln, Germany.
Beyer
D
D
Kaiser
C
C
Horsch
S
S
Wiater
A
A
D000208:Acute Disease; D000293:Adolescent; D001064:Appendicitis / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007079:Ileitis / Q000000981:diagnostic imaging; D007223:Infant; D008199:Lymphadenitis / Q000000981:diagnostic imaging; D008297:Male; D008643:Mesentery; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography