Improved sonographic visualization of the appendix with a saline enema in children with suspected appendicitis.
OBJECTIVE
To determine whether abdominal sonography after a saline enema can identify the appendix that is not visualized at graded compression sonography in children with suspected appendicitis.


METHODS
High-frequency compression sonography was prospectively performed in 120 consecutive children with suspected appendicitis; the appendix was not identified in 27 of these patients. Among the 27 patients with a nonvisualized appendix, abdominal sonography after a saline enema was performed in 12 to identify the appendix.


RESULTS
Abdominal sonography after the saline enema revealed the appendix in all 12 children in whom the appendix was not visualized at graded compression sonography. A normal appendix was found in 11 children, and acute appendicitis confined to the appendiceal tip was found in 1. The appendix was located in the pelvis (n = 5), posterior to the cecum (n = 4), posterior to the ileum (n = 2), and anterior to the ileum (n = 1). The appendix could be identified by using a window of the saline-filled sigmoid colon (n = 5), saline-filled cecum (n = 4), and saline-filled terminal ileum (n = 2).


CONCLUSIONS
Abdominal sonography after a saline enema is a helpful technique for depiction of the appendix that is not visible at graded compression sonography in children with suspected appendicitis. Key words: appendix, sonography; appendicitis; children, gastrointestinal tract.
Han
Tae Il
TI
Department of Radiology, Eulji University School of Medicine, Taejon, Korea.
D000208:Acute Disease; D000293:Adolescent; D001064:Appendicitis / Q000000981:diagnostic imaging*; D001065:Appendix / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D004733:Enema; D005260:Female; D006801:Humans; D007223:Infant; D007422:Intestines / Q000000981:diagnostic imaging; D008297:Male; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage; D014463:Ultrasonography
D012965:Sodium Chloride