Does obesity limit the sonographic diagnosis of appendicitis in children?

Yiğiter, Murat; Kantarcı, Mecit; Yalcin, Onur; Yalçın, Ahmet; Salman, Ahmet Bedii

doi:10.1002/jcu.20782

Cited by 34 publications

(15 citation statements)

References 23 publications

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“…Ortalama doğru tanı %60 (11,25,68,105,154,(176)(177)222,320,321) , yalancı negatif tanı %22 (93,105,126,200,222,223,245,246,278,279,294,320,321) , yalancı pozitif tanı ise %7 (24,93,105,126,222,223,227,228,294) olarak hesaplanmıştır. Bildirilen patolojik bulgu sayı-ları 3-16 arasında değişmekle birlikte en anlamlı kabul edilen bulgular; apandiks çapı artışı, peristaltizm yokluğu, lümeninin bası ile kapatılamaması, serbest sıvı, fekalit ve çevrede inflamasyon varlığıdır (4)(5)(6)24,28,60,64,188,189,204,227,228,245,246,292) .…”

Section: Ultrasonografi (Us)unclassified

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A review of the studies about appendicitis of the Turkish Pediatric Surgical Centers and a preliminary study to form a publishing index for pediatric appendicitis.

Sander¹

2016

Tccd

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Section: Ultrasonografi (Us)unclassified

“…US'de fekalit saptanma sık-lığı %22'dir (64,204,245,246) . Şişmanlığın US bulgularını etkilemediği bildirilmekle birlikte (154,292) , şişman olgularda US dışı görüntüleme yöntemlerinin kullanıl-masının daha doğru olacağı da öne sürülmüştür (23) .…”

Section: Ultrasonografi (Us)unclassified

A review of the studies about appendicitis of the Turkish Pediatric Surgical Centers and a preliminary study to form a publishing index for pediatric appendicitis.

Sander¹

2016

Tccd

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“…[6][7][8][9][10][11] Nevertheless, such findings are by no means universal. [12][13][14][15] Furthermore, none of the studies was conducted with BUS performed in the ED setting.…”

Section: Introductionmentioning

confidence: 99%

“…Two studies found that children with BMI≥85 th percentile have lower appendix ultrasound accuracy, 8,9 and two other studies found that obese children have lower appendix identification rate on ultrasound. 10,11 Other studies have failed to find any relationship between BMI of children and accuracy 14,15 or success 14 of appendix ultrasound. Nevertheless, Abo et al did observe a trend of decreasing ultrasound sensitivity with increasing BMI in their study of 176 children with suspected appendicitis.…”

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confidence: 99%

352 Body Mass Index is a Poor Predictor of Bedside Appendix Ultrasound Success or Accuracy

Lam

Kerwin

Konicki

et al. 2014

Annals of Emergency Medicine

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Introduction:The objective of this study was to determine whether there is a relationship between body mass index (BMI) and success or accuracy rate of beside ultrasound (BUS) for the diagnosis of appendicitis.Methods: Patients four years of age and older presenting to the emergency department with suspected appendicitis were eligible. Enrollment was by convenience sampling. After informed consent, BUS was performed by trained emergency physicians who had undergone a minimum of one-hour didactic training on the use of BUS to diagnose appendicitis. We ascertained subject outcomes by a combination of medical record review and telephone follow up. Calculated BMI for adults and children were divided into four categories (underweight, normal, overweight, obese) according to Centers for Disease Control and Prevention classifications.Results: A total of 125 subjects consented for the study, and 116 of them had adequate image data for final analysis. Seventy (60%) of the subjects were children. Prevalence of appendicitis was 39%. Fiftytwo (45%) of the BUS studies were diagnostic (successful). Overall accuracy rate was 75%. Analysis by chi-square test or Mann-Whitney U test did not find any significant correlation between BMI category and BUS success. Similarly, there was no significant correlation between BMI category and BUS accuracy. The same conclusion was reached when children and adults were analyzed separately, or when subjects were dichotomized into underweight/ normal and overweight/ obese categories. Conclusion:BMI category alone is a poor predictor of appendix BUS success or accuracy. [West J Emerg Med. 2016;17(4) 454-459.] Advocate

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“…15,16 Here, we report our experience with US-guided PCNL in obese patients. The primary aim of this study is to determine how BMI impacts US-guided PCNL, radiation exposure, and perioperative outcomes.…”

mentioning

confidence: 95%

Ultrasound Guidance to Assist Percutaneous Nephrolithotomy Reduces Radiation Exposure in Obese Patients

Usawachintachit

Masic

Chang

et al. 2016

Urology

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OBJECTIVE To evaluate the impact of body mass index (BMI) on perioperative outcomes and radiation exposure for ultrasound (US)-guided percutaneous nephrolithotomy (PCNL). PATIENTS AND METHODS Data were prospectively collected for consecutive patients who underwent PCNL at the University of California, San Francisco, from July 2013 to November 2015. Patients were divided into 3 groups according to their BMI: <25 (normal weight), 25–29.9 (overweight), and >30 (obese) kg/m2. Perioperative outcomes were compared between patients who underwent US-guided vs fluoroscopy-guided PCNL. RESULTS One hundred thirty-five patients were enrolled; 93 cases were performed under US and 42 under fluoroscopic guidance. US successfully guided renal access in 76.9% of normal weight, 79.0% of overweight, and 45.7% of obese patients (P < .05). Mean fluoroscopic screening time and radiation exposure dose were reduced for US compared to fluoroscopy cases across all BMI categories (P < .05). As BMI increased, radiation exposure dose rose disproportionately faster compared to screening time (P < .001). No significant differences among the BMI groups were found with regard to complication rate, hospital stay, and stone-free status. CONCLUSION US-guided PCNL may be more difficult in obese patients, but with its use, the overweight and obese experience the largest absolute reduction in radiation exposure. Because these patients are inherently at greater risk for radiation exposure compared to normal weight patients, they may benefit the most from adoption of US for PCNL.

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Does obesity limit the sonographic diagnosis of appendicitis in children?

Abstract: The findings of our study, in contrast to the findings of other reported studies, demonstrate that obesity does not affect the success rate of US in the visualization of the inflamed appendix in children.

Cited by 34 publications

References 23 publications

A review of the studies about appendicitis of the Turkish Pediatric Surgical Centers and a preliminary study to form a publishing index for pediatric appendicitis.

A review of the studies about appendicitis of the Turkish Pediatric Surgical Centers and a preliminary study to form a publishing index for pediatric appendicitis.

352 Body Mass Index is a Poor Predictor of Bedside Appendix Ultrasound Success or Accuracy

Ultrasound Guidance to Assist Percutaneous Nephrolithotomy Reduces Radiation Exposure in Obese Patients

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