Scientific PapersSelective use of ultrasonography for acute appendicitis in children
Section snippets
Materials and methods
This is a prospective study, performed over a 14-month period. During this time, all consecutive children suspected of having acute appendicitis were considered. On initial evaluation by a pediatric surgeon, patients were placed into three categories: I, acute appendicitis unequivocally; II, equivocal for appendicitis; or III, unequivocally without acute appendicitis. Patients in category III were not enrolled in the study, were not admitted to the pediatric surgery service, and none to our
Results
Of the 116 patients who presented with unequivocal signs of appendicitis, all underwent appendectomy. Seven of the removed appendices were histologically normal. Thus, the false positive rate for patients with unequivocal signs of appendicitis based on clinical findings alone was 6%.
The 99 patients who presented without the classic signs and symptoms of appendicitis underwent ultrasound. Prior to this, initial clinical impression was recorded; it was positive for appendicitis in 26 patients. Of
Comments
The child presenting with abdominal pain is one of the most common pediatric complaints. The diagnosis of acute appendicitis is often straightforward, based on classic history and clinical findings. However, patients are sometimes subjected to periods of observation to confirm or rule out the diagnosis of acute appendicitis. For fear of missing the diagnosis and allowing the development of perforation, peritonitis, and sepsis, a low index of suspicion and early operative intervention have been
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