The Role of Ultrasound and Laboratory Findings for Diagnosis of Appendicitis in Pediatric Patients

Purpose: Acute appendicitis is one of the most common reasons of abdominal surgery in children. The aim of this study was to compare findings of abdomen ultrasonography and laboratory results on the diagnosis of appendicitis in pediatric patients. Materials-Methods: Preopperative ultrasonography and laboratory findings of 114 children (53 girls and 61 boys; mean age: 132 months) who clinically suspected acute appendicitis and undergone appendectomy between January 2007- January 2009 were evaluated retrospectively. If appendix was visualize on US, outer diameter was measured. Six mm or more of outer appendiceal diameter was accepted as a sign of acute appendisicitis. Also periappendicular fluid, lymph node, C-reactive protein (CRP) values, white blood cells and neutrophil percentage were compared with pathologic results. The pathologic diagnosis was the gold standart. Results: Six mm or more of appendiceal diamater was accepted as a sign of acute appendicitis, the corresponding sensitivity, specificity, positive and negative predictive values and accuracy were found 76.40%, 80%, 93.15%, 87.35% and 71.19 % respectively. If 7mm or more of appendiceal diamater accepted as a sign of acute appendicitis, the sensitivity, specificity, positive and negative predictive values and accuracy were found 66.29%, 88% , 95.12%, 42.31% and 71.05% respectively. In patients with acute appendicitis, white blood cells, neutrophil percentage and CRP values were found higher than other patients. There was a significant difference in the white blood cells, neutrophil percentage and CRP values between normal patients and patients with acute appendicitis. There was no significant difference in the presence of periappendicular fluid and lymph node on ultrasonography examination between normal patients and patients with acute appendicitis. Conclusion: Ultrasonography is a cheap, practical and noninvasive method, and does not require ionizing radiation and oral or intravenous contrast material. Therefore, ultrasonography should be used the primary imaging modality for pediatric patients. If ultrasonography is non-diagnostic for appendicitis, computed tomography can be prefered as a second imaging modality [Cukurova Med J 2012; 37(2.000): 84-89]