Accuracy of ultrasonography for differentiating between simple and complex appendicitis in children
link.springer.com shows its articles on its own site.
Read the article on link.springer.com ↗Article · Mar 2021 · 1 min read
In brief
In brief
This retrospective study of 176 pediatric appendicitis cases found that ultrasonography alone has limited accuracy (46% sensitivity, 90% specificity) for distinguishing simple from complex appendicitis. The findings suggest clinicians should integrate ultrasound with clinical examination and laboratory data for optimal preoperative assessment.
Written by the GCMD Library team from the article.
Abstract
Purpose
Accurate differentiation between simple and complex appendicitis is important since differences in treatment exist. This study aimed to assess the accuracy of ultrasonography in differentiating between simple and complex appendicitis.
Methods
Data from children aged < 18 years who underwent appendectomy between the 1st of January 2013 and the 1st of January 2018 were analyzed retrospectively. Ultrasonography reports of eligible children were divided into simple (test negative) and complex appendicitis (test positive) based on predefined criteria and compared to a gold standard (a combination of predefined perioperative and histopathological criteria). Sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) were calculated to measure ultrasonographic accuracy in differentiating between simple and complex appendicitis.
Results
176 children were eligible for inclusion. The mean age at the time of operation was 10.1 ± SD 4.6 years. 84 (47.7%) children had simple appendicitis and 92 (52.3%) had complex appendicitis. The use of ultrasonography yielded a sensitivity: 46%, specificity: 90%, PPV: 84%, and NPV: 60%.
Conclusion
Ultrasonography as standalone modality is not suitable for differentiating between simple and complex appendicitis in children. To improve preoperative differentiation, other variables such as clinical signs and laboratory data are necessary in conjunction with ultrasonography findings.