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European Radiology

, Volume 19, Issue 2, pp 455–461

First Online: 25 September 2008Received: 02 May 2008Revised: 16 August 2008Accepted: 22 August 2008

Abstract

This study evaluated the additional value of secondary signs in the diagnosing of appendicitis in children with ultrasound. From May 2005 to June 2006, 212 consecutive paediatric patients with suspected appendicitis were examined. Ultrasonographic depiction of the appendix was classified into four groups: 1, normal appendix; 2, appendix not depicted, no secondary signs of appendicitis; 3, appendix not depicted with one of the following secondary signs: hyperechoic mesenteric fat, fluid collection, local dilated small bowel loop; 4, depiction of inflamed appendix. We classified 96 patients in group 1, 41 in group 2, 13 in group 3, and 62 in group 4. Prevalence of appendicitis was 71-212 34%. Negative predictive values of groups 1 and 2 were 99% and 100%, respectively. Positive predictive values of groups 3 and 4 were 85% and 95%, respectively. In groups 3 and 4, hyperechoic mesenteric fat was seen in 73-75 97.3%, fluid collections and dilated bowel loops were seen in 12-75 16.0% and 5-75 6.6%, respectively. This study shows that in case of non-visualization of the appendix without secondary signs, appendicitis can be safely ruled out. Furthermore, secondary signs of appendicitis alone are a strong indicator of acute appendicitis.

KeywordsPaediatric Ultrasound Appendicitis Normal appendix Secondary signs  Download fulltext PDF



Autor: Fraukje Wiersma - Boudewijn R. Toorenvliet - Johan L. Bloem - Jan Hein Allema - Herma C. Holscher

Fuente: https://link.springer.com/







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