Diagnostic accuracy of surgeon performed ultrasound (SPU) for appendicitis in children

Soundappan, SS; Karpelowsky, J; Lam, A; Lam, L; Cass, D

Diagnostic accuracy of surgeon performed ultrasound (SPU) for appendicitis in children

Soundappan, SS Karpelowsky, J Lam, A Lam, L

Cass, D

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Publication Type:: Journal Article
Citation:: Journal of Pediatric Surgery, 2018, 53 (10), pp. 2023 - 2027
Issue Date:: 2018-10-01

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Field	Value	Language
dc.contributor.author	Soundappan, SS	en_US
dc.contributor.author	Karpelowsky, J	en_US
dc.contributor.author	Lam, A	en_US
dc.contributor.author	Lam, L https://orcid.org/0000-0001-6183-6854	en_US
dc.contributor.author	Cass, D	en_US
dc.date.available	2018-05-18	en_US
dc.date.issued	2018-10-01	en_US
dc.identifier.citation	Journal of Pediatric Surgery, 2018, 53 (10), pp. 2023 - 2027	en_US
dc.identifier.issn	0022-3468	en_US
dc.identifier.uri	http://hdl.handle.net/10453/129344
dc.description.abstract	© 2018 Aim: Compare the diagnostic accuracy of surgeon performed ultrasound to radiology performed ultrasound in children presenting with suspected appendicitis to a tertiary care pediatric hospital in Australia. Methods: Children under 16 presenting to the emergency department of The Children's Hospital at Westmead were considered for the study. Patients with obvious signs of appendicitis not requiring ultrasound and those with established ultrasound diagnosis of appendicitis were excluded. Ultrasound was performed by a Pediatric Surgeon (SPU) after obtaining consent. The treating team was blinded to the results. Patient underwent formal ultrasound in radiology (RPU) and treatment was based on the formal report. SPU result was reviewed by a radiologist blinded to results of RPU. The results were compared. Results: 65 children underwent ultrasound. 35 were male. Median age was 10 (range3–15). Median weight was 36 kg (range 12.6–76.2 kg), z-score median 0.21 (− 1.83 to 2.74). Symptom duration ranged from few hours to 2 weeks but majority (45) had symptoms for less than 48 h. Prevalence of appendicitis was 45%. Thirty two underwent surgery. Negative appendicectomy rate was 9.4%. Thirty three did not have surgery. 8 represented but only one proceeded to appendicectomy. SPU was done earlier than RPU (median 12 h vs 14.15 h) p = 0.088. Diagnostic accuracy using ROC did not reveal significant difference. Conclusion: SPU can be performed earlier than RPU with reliable accuracy. Training surgical trainees will enable early diagnosis and management of appendicitis.	en_US
dc.relation.ispartof	Journal of Pediatric Surgery	en_US
dc.relation.isbasedon	10.1016/j.jpedsurg.2018.05.014	en_US
dc.subject.classification	Pediatrics	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Appendicitis	en_US
dc.subject.mesh	Ultrasonography	en_US
dc.subject.mesh	Predictive Value of Tests	en_US
dc.subject.mesh	Adolescent	en_US
dc.subject.mesh	Child	en_US
dc.subject.mesh	Child, Preschool	en_US
dc.subject.mesh	Hospitals, Pediatric	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Surgeons	en_US
dc.title	Diagnostic accuracy of surgeon performed ultrasound (SPU) for appendicitis in children	en_US
dc.type	Journal Article
utslib.citation.volume	10	en_US
utslib.citation.volume	53	en_US
utslib.for	1114 Paediatrics and Reproductive Medicine	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	closed_access
pubs.issue	10	en_US
pubs.publication-status	Published	en_US
pubs.volume	53	en_US

Abstract:

© 2018 Aim: Compare the diagnostic accuracy of surgeon performed ultrasound to radiology performed ultrasound in children presenting with suspected appendicitis to a tertiary care pediatric hospital in Australia. Methods: Children under 16 presenting to the emergency department of The Children's Hospital at Westmead were considered for the study. Patients with obvious signs of appendicitis not requiring ultrasound and those with established ultrasound diagnosis of appendicitis were excluded. Ultrasound was performed by a Pediatric Surgeon (SPU) after obtaining consent. The treating team was blinded to the results. Patient underwent formal ultrasound in radiology (RPU) and treatment was based on the formal report. SPU result was reviewed by a radiologist blinded to results of RPU. The results were compared. Results: 65 children underwent ultrasound. 35 were male. Median age was 10 (range3–15). Median weight was 36 kg (range 12.6–76.2 kg), z-score median 0.21 (− 1.83 to 2.74). Symptom duration ranged from few hours to 2 weeks but majority (45) had symptoms for less than 48 h. Prevalence of appendicitis was 45%. Thirty two underwent surgery. Negative appendicectomy rate was 9.4%. Thirty three did not have surgery. 8 represented but only one proceeded to appendicectomy. SPU was done earlier than RPU (median 12 h vs 14.15 h) p = 0.088. Diagnostic accuracy using ROC did not reveal significant difference. Conclusion: SPU can be performed earlier than RPU with reliable accuracy. Training surgical trainees will enable early diagnosis and management of appendicitis.

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http://hdl.handle.net/10453/129344