[Diagnostic surplus value of echography in children with acute abdominal pain].
OBJECTIVE
To assess the role of echography in the diagnosis of acute abdominal symptoms in children.


METHODS
Prospective, descriptive.


METHODS
During one year (1 June 1999-31 May 2000), abdominal ultrasonography was performed in all children with abdominal pain less than 2 weeks, who were referred to the emergency department of the Red Cross Hospital in The Hague (the Netherlands). An initial clinical diagnosis was made on the basis of the medical history, a physical examination and the results of laboratory tests. Subsequently, ultrasonography was performed by a radiologist who was unaware of the clinical diagnosis. A working hypothesis was reached on the basis of the clinical findings and the results of echography. The final diagnosis was made on the basis of either a histologic investigation after surgery or the condition at discharge.


RESULTS
The study included 112 patients. The mean age was 9 years and 54% were boys. Acute appendicitis was ascertained in 48 children. The sensitivity of the clinical findings was 88% and the specificity 70%. The sensitivity of the clinical findings together with ultrasonography was 88% and the specificity 91%. The positive predictive value of the clinical findings alone was 69% and of the clinical findings together with ultrasonography 88%.


CONCLUSIONS
Echography has added value in the diagnosis of acute abdominal pain in children; it increases the specificity of the physical examination. The number of negative laparotomies was decreased by the use of ultrasonography.
van den Ende
E D
ED
Afd. Heelkunde, Iuliana Kinderziekenhuis/Rode Kruis Ziekenhuis, Sportlaan 600, 2566 MJ Den Haag.
Boellaard
W P
WP
Allema
J H
JH
Holscher
H C
HC
Putter
H
H
Breslau
P J
PJ
D000006:Abdomen, Acute / Q000175:diagnosis / Q000000981:diagnostic imaging*; D015746:Abdominal Pain / Q000175:diagnosis / Q000000981:diagnostic imaging*; D000293:Adolescent; D001064:Appendicitis / Q000175:diagnosis / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008487:Medical History Taking; D010808:Physical Examination; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography