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Original Article

Cause of Abdominal Ultrasound Diagnostic Errors in Children with Acute Appendicitis

Yoo Mi Kim, Jae Hee Chung
Journal of the Korean Association of Pediatric Surgeons 2016;22(2):33-37.
Published online: December 22, 2016

Department of Surgery, Yeouido St. Mary's Hospital, School of Medicine, The Catholic University of Korea, Seoul, Korea.

Correspondence: Jae Hee Chung, Department of Surgery, Yeouido St. Mary's Hospital, School of Medicine, The Catholic University of Korea, 10 63-ro, Yeongdeungpo-gu, Seoul 07345, Korea. Tel: +82-2-3779-1040, Fax: +82-2-786-0802, jhjung@catholic.ac.kr
• Received: June 13, 2016   • Revised: September 12, 2016   • Accepted: October 11, 2016

Copyright © 2016 by the Korean Association of Pediatric Surgeons

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The use of CT as a diagnostic tool in pediatric acute appendicitis is increasing because of its high sensitivity and specificity. However, due to both the serious concerns about radiation of CT and the convenience and reasonable cost of ultrasound (US) examination, US has value on the initial diagnosis of acute appendicitis despite of the lower sensitivity in children. The purpose of this study was to examine the factors that affect the rate of false negative diagnosis of the ultrasound from the patients who received laparoscopic appendectomy.
  • Methods
    The pediatric appendectomy cases from 2002 to 2013 in Yeouido St. Mary's Hospital have been reviewed through the medical records. We included patients who underwent an initial screening by ultrasound examination.
  • Results
    Among 181 patients, 156 patients were the sono-positive group and 25 patients were sono-negative group. There is no significant difference in ages, genders, physical examination findings and white blood cell count between the two groups. But, the degree of inflammation of appendicitis (simple, 58.3% vs. 32.0%; complicated, 41.7% vs. 68.0%) and the appendix position (antececal, 85.0% vs. 12.0%; retrocecal, 13.7% vs. 44.0%; pelvic, 1.3% vs. 44.0%) were significantly different between the two groups (sono-positive group vs. sono-negative group; p<0.05).
  • Conclusion
    The position of the appendix may act as a factor that causes an error in the diagnostic ultrasound, especially, in the retrocecal type and the pelvic type with the higher risk of necrosis or perforation.
  • Keywords: Appendicitis; Ultrasonography; Diagnostic errors

No potential conflict of interest relevant to this article was reported.

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Table 1

Characteristics of Patients Who Received Appendectomy with Acute Appendicitis (n=181)

Values are presented as mean±SD or n (%).

Seg., segmented; exam., examination; RLQ, right lower quadrant; DT, direct tenderness; RT, rebound tenderness; MG, muscle guarding.

jkaps-22-33-i001.jpg
Table 2

Characteristics of Patients with Negative Ultrasonographic Finding (n=25)

jkaps-22-33-i002.jpg

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Cause of Abdominal Ultrasound Diagnostic Errors in Children with Acute Appendicitis
J Korean Assoc Pediatr Surg. 2016;22(2):33-37.   Published online December 22, 2016
DOI: https://doi.org/10.13029/jkaps.2016.22.2.33
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
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Include:
Cause of Abdominal Ultrasound Diagnostic Errors in Children with Acute Appendicitis
J Korean Assoc Pediatr Surg. 2016;22(2):33-37.   Published online December 22, 2016
DOI: https://doi.org/10.13029/jkaps.2016.22.2.33
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Cause of Abdominal Ultrasound Diagnostic Errors in Children with Acute Appendicitis
Cause of Abdominal Ultrasound Diagnostic Errors in Children with Acute Appendicitis

Characteristics of Patients Who Received Appendectomy with Acute Appendicitis (n=181)

Values are presented as mean±SD or n (%).

Seg., segmented; exam., examination; RLQ, right lower quadrant; DT, direct tenderness; RT, rebound tenderness; MG, muscle guarding.

Characteristics of Patients with Negative Ultrasonographic Finding (n=25)

Table 1 Characteristics of Patients Who Received Appendectomy with Acute Appendicitis (n=181)

Values are presented as mean±SD or n (%).

Seg., segmented; exam., examination; RLQ, right lower quadrant; DT, direct tenderness; RT, rebound tenderness; MG, muscle guarding.

Table 2 Characteristics of Patients with Negative Ultrasonographic Finding (n=25)

Table 1

Table 2

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