Surgeon-performed ultrasound: accurate, reproducible, and more efficient.
OBJECTIVE
A study previously performed at our institution demonstrated that surgeon-performed ultrasound (SPUS) was accurate compared to radiology department ultrasound (RDUS) when evaluating children with suspected appendicitis. The purpose of this study was to determine if these results were reproducible and if SPUS decreased time to definitive diagnosis.


METHODS
A surgery resident performed examinations and ultrasounds on children with suspected appendicitis. Final diagnosis was confirmed by pathology. Results were compared to RDUS and combined with the previous study for a final comparison with RDUS. Mean time to diagnosis was recorded. Data were analyzed using Fisher exact and Student's t test.


RESULTS
Fifty-eight patients underwent SPUS, of these 35 had RDUS. The accuracy of SPUS alone was 93% (54/58) and RDUS accuracy was 94% (33/35) (p = 1). When SPUS was combined with clinical examination accuracy increased to 95% (55/58). When results were combined with the previous study, overall accuracy of SPUS was 90% (101/112) compared to overall RDUS accuracy of 89 % (50/56). Mean time to diagnosis for RDUS was 135 min (n = 35), whereas mean time to diagnosis for SPUS was 30 min (n = 58; p = 0.0001).


CONCLUSIONS
SPUS is accurate and reproducible in evaluating children with suspected appendicitis. SPUS potentially decreases time to definitive therapy and emergency department wait times.
Department of Pediatric Surgery, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, 1 Children's Way, Slot 837, Little Rock, AR, 72202, USA. dlwyrick@uams.edu.
Deidre L
DL
Wyrick
Department of Pediatric Surgery, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, 1 Children's Way, Slot 837, Little Rock, AR, 72202, USA.
Samuel D
SD
Smith
Department of Pediatric Surgery, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, 1 Children's Way, Slot 837, Little Rock, AR, 72202, USA.
Jeffrey M
JM
Burford
Department of Pediatric Surgery, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, 1 Children's Way, Slot 837, Little Rock, AR, 72202, USA.
Melvin S
MS
Dassinger
D000293:Adolescent; D000328:Adult; D001064:Appendicitis / Q000000981:diagnostic imaging*; D001065:Appendix / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D066231:Surgeons; D014463:Ultrasonography; D055815:Young Adult
Appendicitis; SPUS; Surgeon-performed ultrasound; Ultrasound