Ultrasonography aids decision-making in children with abdominal pain

被引:14
|
作者
Scammell, S. [1 ]
Lansdale, N.
Sprigg, A. [2 ]
Campbell, D. [3 ]
Marven, S.
机构
[1] Sheffield Childrens Hosp, Paediat Surg Unit, Western Bank, Sheffield S10 2TH, S Yorkshire, England
[2] Sheffield Childrens Hosp, Dept Radiol, Sheffield S10 2TH, S Yorkshire, England
[3] Sheffield Childrens Hosp, Dept Paediat, Sheffield S10 2TH, S Yorkshire, England
关键词
Appendicitis; Ultrasonography; Child; Abdomen; acute; ACUTE APPENDICITIS; SUSPECTED APPENDICITIS; PEDIATRIC APPENDICITIS; MANAGEMENT; CT; DIAGNOSIS; SONOGRAPHY; ULTRASOUND; IMPACT; US;
D O I
10.1308/003588411X582672
中图分类号
R61 [外科手术学];
学科分类号
摘要
INTRODUCTION Although regular clinical assessment of the acute abdomen is considered best practice, ultrasonography confirming the presence of appendicitis will add to the decision-making process. The aim of this study was to assess the accuracy of ultrasonography and its usefulness in diagnosing acute appendicitis in a regional paediatric surgical institution. METHODS Retrospectively and in this order, radiology, theatre and histopathology databases were searched for patients who had presented with acute abdominal pain, patients who had undergone an appendicectomy and all appendix specimens over a two-year period. The databases were cross-referenced against each other. RESULTS A total of 273 non-incidental appendicectomies were performed over the study period. The negative appendicectomy rate was 16.5% and the perforation rate 23.7%. Thirty-nine per cent of children undergoing an appendicectomy had at least one pre-operative ultrasound scan. Ultrasonography as a diagnostic tool for acute appendicitis in children had a sensitivity of 83.3%, a specificity of 97.4%, a positive predictive value of 92.1% and a negative predictive value of 94.0%. CONCLUSIONS Ultrasonography is used liberally to aid in the decision making process of equivocal and complicated cases of acute appendicitis and it achieves good measures of accuracy. As a diagnostic tool it is unique in its ability to positively predict as well as exclude. A high negative predictive value suggests that more patients could be managed on an outpatient basis following a negative scan.
引用
收藏
页码:405 / 409
页数:5
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