Utilization of Diagnostic Ultrasound in Pediatric Appendicitis

An acute appendicitis, inflammation of the appendix, is one of the most common causes of abdominal pain requiring interventions such as surgery, antibiotics, further evaluation, or simply observation.1 Although, the patient history and physical exam is the most important component in diagnosing an appendicitis, confirmation with imaging is often requested prior to surgical intervention. Ultrasonography (US) has been found useful in diagnosing an appendicitis but how reliable and efficient is it? Ultrasonography (US) has a sensitivity of 85% and specificity greater than 90% if performed and interpreted by skilled sonographers and radiologists.2 Criteria for diagnosing an appendicitis via US include a non-compressible appendix measuring 7mm or larger in diameter, wall thickening greater than 2mm or irregular rigid walls, and lacks peristalsis.2-4 Disadvantages associated with US include operator experience, lack of regular availability of US, and difficulty visualizing the appendix in obese children.2-4 Computer tomography (CT) is proven to be a more accurate diagnostic tool in pediatric appendicitis at the cost of exposing them to radiation. This review discusses the benefits, disadvantages, and other tools used to improve chances of properly diagnosing an acute appendicitis