Diagnostic yield of abdominal ultrasonography in acute appendicitis

• Published in: Anales de pediatría (Barcelona, Spain : 2003) Vol. 58; no. 6; pp. 556 - 561
• Main Authors: Vázquez Ronco, M A, Morteruel Arizkuren, E, García Ojeda, E, Mintegui Raso, S, Capapé Zache, S, Benito Fernández, J
• Format: Journal Article
• Language: Spanish
• Published: Spain 01-06-2003
• Subjects: Acute Disease; Adolescent; Appendicitis - diagnostic imaging; Appendicitis - epidemiology; Child; Humans; Predictive Value of Tests; Retrospective Studies; Ultrasonography
• ISSN: 1695-4033

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