title: Acute abdominal pain in childhood and adolescence: assessing the impact of sonography on diagnosis and treatment.
abstract: OBJECTIVE
  To assess the impact of ultrasonography on defining the diagnostic and therapeutic pathways for pediatric patients admitted to the emergency department for acute abdominal pain.
  
  
  METHODS
  We performed a retrospective study of all patients aged <16 years with acute abdominal pain who underwent ultrasound examination at our Diagnostic Imaging Department from October 2010 to March 2012. We investigated for each patient the pathway following ultrasound examination and definitive diagnosis. The impact of ultrasonography was defined based on the frequency with which the information resulting from this examination confirmed or denied the diagnostic suspicion made by the emergency physician on the basis of clinical and laboratory findings.
  
  
  RESULTS
  In 497/729 patients (69 %), ultrasound examination did not determine variations in the diagnostic and therapeutic pathways, either because it confirmed the outcome of clinical examination and laboratory tests, or because, even addressing in the opposite direction to these, the emergency physician did not consider its result because of being particularly alarmed or sufficiently reassured by clinical examination and laboratory tests. In the remaining 232/729 cases (31 %), ultrasound examination determined an increase or a reduction of the provided care and attention (subsequently proved justified in the vast majority of cases) in spite of what was initially assessed based on clinical examination and laboratory tests.
  
  
  CONCLUSIONS
  The results of our retrospective study demonstrated that ultrasonography was a valuable tool in the management of pediatric patients with acute abdominal pain together with clinical examination and laboratory tests.
authors.affiliation: Department of Diagnostic Imaging, Ospedale San Giuseppe Moscati, Aversa, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Russo
authors.affiliation: Scientific Section of Radiology, Unit of Radiology, Radiotherapy and Nuclear Medicine, Department of Clinical and Experimental Internal Medicine "F. Magrassi e A. Lanzara", Primo Policlinico di Napoli, Second University of Naples, 5, Piazza Miraglia, 80131 Naples, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Cappabianca
authors.affiliation: Scientific Section of Radiology, Unit of Radiology, Radiotherapy and Nuclear Medicine, Department of Clinical and Experimental Internal Medicine "F. Magrassi e A. Lanzara", Primo Policlinico di Napoli, Second University of Naples, 5, Piazza Miraglia, 80131 Naples, Italy ; 118, Corso Umberto I, 80138 Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Iaselli
authors.affiliation: Scientific Section of Radiology, Unit of Radiology, Radiotherapy and Nuclear Medicine, Department of Clinical and Experimental Internal Medicine "F. Magrassi e A. Lanzara", Primo Policlinico di Napoli, Second University of Naples, 5, Piazza Miraglia, 80131 Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Reginelli
authors.affiliation: Department of Diagnostic Imaging, Ospedale San Giuseppe Moscati, Aversa, Italy.
authors.forename: A
authors.initials: A
authors.lastname: D'Andrea
authors.affiliation: Department of Diagnostic Imaging, Ospedale San Giuseppe Moscati, Aversa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Mazzei
authors.affiliation: Department of Diagnostic Imaging, Ospedale San Giuseppe Moscati, Aversa, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Martiniello
authors.affiliation: Scientific Section of Radiology, Unit of Radiology, Radiotherapy and Nuclear Medicine, Department of Clinical and Experimental Internal Medicine "F. Magrassi e A. Lanzara", Primo Policlinico di Napoli, Second University of Naples, 5, Piazza Miraglia, 80131 Naples, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Grassi
authors.affiliation: Scientific Section of Radiology, Unit of Radiology, Radiotherapy and Nuclear Medicine, Department of Clinical and Experimental Internal Medicine "F. Magrassi e A. Lanzara", Primo Policlinico di Napoli, Second University of Naples, 5, Piazza Miraglia, 80131 Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Rotondo
keywords: Acute abdominal pain; Adolescence; Appendicitis; Childhood; Ultrasonography