The Prognostic Value of Ultrasound Findings in Preoperatively Distinguishing between Uncomplicated and Complicated Types of Pediatric Acute Appendicitis Based on Correlation with Intraoperative and Histopathological Findings

被引:7
作者
Bekiaridou, Konstantina [1 ]
Kambouri, Katerina [1 ]
Giatromanolaki, Alexandra [2 ]
Foutzitzi, Soultana [3 ]
Kouroupi, Maria [2 ]
Chrysafis, Ioannis [3 ]
Deftereos, Savas [3 ]
机构
[1] Democritus Univ Thrace, Dept Pediat Surg, Alexandroupolis 68100, Greece
[2] Democritus Univ Thrace, Dept Pathol, Alexandroupolis 68100, Greece
[3] Democritus Univ Thrace, Dept Radiol, Alexandroupolis 68100, Greece
关键词
ultrasound; complicated appendicitis; uncomplicated appendicitis; DIAGNOSIS; CHILDREN; APPENDECTOMY; CT; US;
D O I
10.3390/diagnostics12102315
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: This study compares the preoperative ultrasound findings of all children with a clinical picture of acute appendicitis on the basis of intraoperative and histopathological findings to assess the feasibility of this approach in preoperatively distinguishing between uncomplicated and complicated cases. Methods: This retrospective study includes 224 pediatric patients who underwent ultrasound prior to appendectomy at our institution between January 2016 and February 2022. Logistic regression analysis was used to investigate the association between sonographic and intraoperative histopathological findings. Results: Of the 224 participants, 61.1% were intraoperatively diagnosed with uncomplicated appendicitis (59.8% male). Multivariate logistic regression analysis revealed that patients with a higher appendiceal diameter, presence of appendicolith, and peritonitis were more likely to suffer from complicated appendicitis. Finally, the common anatomical position of the appendix and an appendiceal diameter greater than 6 mm had the highest sensitivity (94.6% and 94.5%, respectively) for predicting complicated appendicitis, with the most specific (99.3%) sonographic finding being the existence of an abscess. Conclusions: Preoperative abdominal ultrasound in children with a clinical diagnosis of acute appendicitis can distinguish between uncomplicated and complicated appendicitis in most cases of pediatric appendicitis. A higher appendiceal diameter, the presence of appendicolith, and peritonitis are parameters noted by ultrasound that strongly predict complicated appendicitis.
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页数:12
相关论文
共 46 条
[1]  
Al-Khusheh M., 2011, J MED MED SCI, V2, P1216
[2]   Acute appendicitis in young children less than 5 years: review article [J].
Almaramhy, Hamdi Hameed .
ITALIAN JOURNAL OF PEDIATRICS, 2017, 43 :1-9
[3]   Sedation/anaesthesia in paediatric radiology [J].
Arlachov, Y. ;
Ganatra, R. H. .
BRITISH JOURNAL OF RADIOLOGY, 2012, 85 (1019) :E1018-E1031
[4]  
Ashjaei Bahar, 2022, Afr J Paediatr Surg, V19, P13, DOI 10.4103/ajps.AJPS_124_20
[5]   Abscess and symptoms duration upon presentation should guide decision algorithms for early versus interval appendectomy in children [J].
Badru, Faidah ;
Piening, Nicholas ;
Abraham, Armando Salim Munoz ;
Osei, Hector ;
Greenspon, Jose ;
Chatoorgoon, Kaveer ;
Fitzpatrick, Colleen ;
Villalona, Gustavo A. .
PEDIATRICS AND NEONATOLOGY, 2019, 60 (05) :530-536
[6]   Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management [J].
Bhangu, Aneel ;
Soreide, Kjetil ;
Di Saverio, Salomone ;
Assarsson, Jeanette Hansson ;
Drake, Frederick Thurston .
LANCET, 2015, 386 (10000) :1278-1287
[7]   Accuracy of imaging in discriminating complicated from uncomplicated appendicitis in daily clinical practice [J].
Bolmers, Matthijs D. M. ;
Bom, Wouter J. ;
Scheijmans, Jochem C. G. ;
van Geloven, Anna A. W. ;
Boermeester, Marja. A. ;
Bemelman, Willem A. ;
van Rossem, Charles. C. .
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, 2022, 37 (06) :1385-1391
[8]  
Castro BA, 2019, REV PAUL PEDIATR, V37, P161, DOI 10.1590/1984-0462/
[9]  
2019
[10]  
37