[Diagnostic yield of abdominal ultrasonography in acute appendicitis].
BACKGROUND
Acute appendicitis (AA) is the first cause of surgical abdomen in childhood but diagnosis continues to be difficult in some cases. Abdominal ultrasonography has been shown to be useful when there is doubt about the diagnosis and can be quickly and easily performed at the patient's bedside.


OBJECTIVE
To evaluate the efficacy of abdominal ultrasonography in the diagnosis of acute appendicitis in our hospital.


METHODS
All patients who visited the emergency department for abdominal pain and who underwent abdominal ultrasonography to rule out AA between January 1, 1999 and December 31, 2000 were retrospectively studied.


RESULTS
During the study period, 4217 children were evaluated in our service for abdominal pain. Ultrasonography was performed in 528 children. Of these, the procedure was performed to rule out AA in 308 patients. Of these 308 patients who met the study's inclusion criteria, the results of ultrasonography were compatible with AA in 102 and were normal in 196. Ultrasonographic diagnosis differed from the final diagnosis in 16 patients. In eight children with ultrasonographic findings suggestive of AA, laparotomy revealed normal appendices. In the remaining eight patients, ultrasonographic findings were normal and surgery revealed AA. Based on these findings, the diagnostic yield of abdominal ultrasonography was: sensitivity: 96.6 %; specificity: 95.9 %, positive predictive value: 86 %; negative predictive value: 95.9 %.


CONCLUSIONS
The overall diagnostic yield of abdominal ultrasonography in AA our hospital is acceptable. Because ultrasonographic diagnosis is not always accurate, others diagnostic methods such as computed tomography should be used in doubtful cases.
Vázquez Ronco
M A
MA
Urgencias de Pediatría. Hospital de Cruces. Barakaldo. Vizcaya. España. mvazquez@hcru.osakidetza.net
Morteruel Arizkuren
E
E
García Ojeda
E
E
Mintegui Raso
S
S
Capapé Zache
S
S
Benito Fernández
J
J
D000208:Acute Disease; D000293:Adolescent; D001064:Appendicitis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002648:Child; D006801:Humans; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014463:Ultrasonography