The Value of Ultrasonography in Diagnosis of Acute Appendicitis in Pediatric Age Group

Abstract

BACKGROUND

Acute appendicitis is one of the most common surgical emergency condition in pediatric age group that need admission to pediatric surgery unit for emergent operation of appendectomy . Any delayed in the diagnosis and operation lead to very serious outcome ,including perforation , abscess formation and appendiceal mass formation and other complications which may lead to high mortality and morbidity rate in case of absence timely performed operation of appendectomy .

Ultrasound (USG)is one of the most helpful and informative tool in diagnosis of acute appendicitis in children.it is simple , fast , available and with less complications of ionizing radiation that may associated with other modality of radiological methods , like CT .

Aims of the study

Evaluate the role of USG examination in :-

1-diagnosis of children with suspected appendicitis

2-defining the sensitivity , specificity and the accuracy rate of acute appendicitis in pediatric age group.

3-Decreasing the normal appendectomy in pediatric age group/.

patients and method

This prospective study has been achieved in the central child teaching hospital in Baghdad during the period from February 2015 to December 2015, that enrolled 110 patients that were admitted pediatric surgery Center in Central Child Hospital in Baghdad who were complained from right lower abdominal pain and acute appendicitis was highly suspected at time of examination .USG examination had been done to these patients.

Result

Clinical presentation and USG criteria of acute appendicitis had been found in 57 cases out of 110 patients , and those underwent appendectomy operation in the Central Child Teaching Hospital in Baghdad .

Unvisualization of appendix or normal ultrasonography criteria had been found in 53 patients.

6 patients out of the those of 53 patients with negative USG finding underwent appendectomy operation due to persistence of clinical finding, 3 of them were with normal appendix while the 3 others were with inflamed appendix according to histopathological examination.

The other 47 patients from 53 cases who were complain from right lower abdominal pain, but with negative USG findings , kept for observation for 24 hours and then discharged home with follow up these cases by clinical examination and USG once weekly for 2 weeks.

The overall result of a study is as follow :-

Specificity = 100%

Sensitivity = 95%

Accuracy rate =97.27%

Positive predictive value =100%

negative predictive value = 50%

conclusion

ultrasonographic examination have effective role in diagnosis of acute appendicitis in pediatric age group. Keywords:Acute appendicitis , ultrasonogaphy in acute appendicitis , sensitivity , specificity , accuracy rate.

DOI: 10.7176/JHMN/73-06

Publication date: April 30^th 2020