The use of computed tomography versus clinical acumen in diagnosing appendicitis in children: A two-institution international study

El-Gohary, Yousef; Molina, Marı́a Teresa; Chang, Jeremy; Dodd, Ashley C.; Miller, Emily; Harrell, Camden; Wang, Fang; Zhang, Hui; Davidoff, Andrew M.; Fernández-Pineda, Israel; Huang, Eunice Y.

doi:10.1016/j.jpedsurg.2020.09.061

Cited by 11 publications

(7 citation statements)

References 32 publications

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“…In a study evaluated the diagnostic performance of CT imaging in children with AA, diagnostic accuracy of 95.6%, sensitivity of 97.3%, speci city of 93.7%, PPV of 89.0% and NPV of 98.7% were measured (16). In a study comparing the differences in imaging modality use and associated outcomes for AA between two pediatric hospitals in the United States and Spain, the diagnostic accuracy of abdominal CT was reported to be 94.7% and 95%, respectively (17). In our study, the sensitivity and speci city of CT in the diagnosis of AA were 88.1% and 57.1%, respectively.…”

Section: Resultsmentioning

confidence: 46%

“…The previous studies showed that abdominal CT can be more effective in making a timely and accurate diagnosis, since abdominal US has a wide range of sensitivity and speci city (15)(16)(17). Although it is recommended to perform the examination with contrast, it was stated that non-contrast CT examinations with appropriate cross-sections may also be su cient for the diagnosis (15).…”

Section: Resultsmentioning

confidence: 99%

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WITHDRAWN: Diagnostic value of ultrasonography and computed tomography in pathology-confirmed acute appendicitis in children

Baykara

Kılıç

2022

Preprint

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Objective and aim: Acute appendicitis (AA), the most common cause of acute abdomen in childhood, can cause high morbidity and mortality if not diagnosed and treated on the time. Diagnosis of AA is more difficult in children due to the limited communication skills, in comparison to adults. The aim of this study is to evaluate the diagnostic efficacy of abdominal ultrasonography (US) and computed tomography (CT) in the diagnosis of AA in children. Materials and methods Pediatric patients who were operated on the diagnosis of AA between January 2016 and December 2021 were retrospectively reviewed. Preoperative abdominal US and CT findings of the patients and postoperative pathology results were recorded. Results A total of 251 patients with a mean age of 11.3 years were included in the study. There were 154 (61.4%) males and 97 (38.6%) females. Histopathology revealed AA in 215 (85.7%) patients. Preoperatively, US and CT were performed in 139 (55.3%) and 137 (54.5%) patients, respectively. US had a sensitivity and specificity rate of 77.2% and 52.6%, respectively. Pozitive predictive value (PPV) was found to be 81.2% whereas negative predictive value (NPV) was 46.5% for US. Diagnostic accuracy rate of US was found as 70.5%. CT had a sensitivity and specificity rate of 88.1% and 57.1%, respectively. PPV was found to be 88.8% whereas NPV was 55.1% for CT. Diagnostic accuracy rate of CT was found as 81.8%. Conclusion In case of suspicion of AA, US may be the first choice because it is inexpensive, and easily accessible. However, considering the patient incompatibility and subjective factors in children, US may sometimes be unsufficient. We think that CT should be performed as an advanced examination method in cases where US is not compatible with the patient's clinic.

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Section: Resultsmentioning

confidence: 46%

Section: Resultsmentioning

confidence: 99%

WITHDRAWN: Diagnostic value of ultrasonography and computed tomography in pathology-confirmed acute appendicitis in children

Baykara

Kılıç

2022

Preprint

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“…However, the identification of patients with non-complicated AA is still challenging. As CT scans involve radiation and are generally avoided for pediatric diagnostics [ 74 ], the prediction of complicated AA typically relies on patient history, clinical findings, laboratory values such as WBC count, granulocyte count, CRP concentration, and ultrasound [ 75 , 76 ]. Many efforts have been made to find new biomarkers to help differentiate between complicated and uncomplicated appendicitis [ 77 ].…”

Section: Acute Appendicitismentioning

confidence: 99%

NETworking for Health and in Disease: Neutrophil Extracellular Traps in Pediatric Surgical Care

Dölling,

Herrmann,

Boettcher

2024

Children

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This comprehensive review examines the role of Neutrophil Extracellular Traps (NETs) in pediatric surgery. Focusing on NET formation, functions, and implications, this study highlights their dual impact in infection control and contribution to tissue damage after surgery. It covers the role of NET formation in a range of pediatric conditions including immunothrombosis, formation of peritoneal adhesions, appendicitis, burns, gallstones, tumors, and necrotizing enterocolitis (NEC). The results underscore the significance of NETs in fighting infections and their association with complications like sepsis and delayed wound healing. The breakdown products of NETs as a diagnostic tool of the clinical course of acute appendicitis will also be discussed. Understanding NET formation in the pathophysiology can potentially help to find new therapeutic approaches such as the application of DNase and elastase inhibitors to change the clinical course of various diseases in pediatric surgery such as improvement of wound healing, adhesion formation, NEC, and many more.

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“…When a patient presents with abdominal pain in the right lower quadrant, acute appendicitis is a commonly suspected pathology. To determine whether to perform surgery, the patients are clinically assessed, and often preoperative imaging is used as a supplement to diagnose appendicitis [2,3]. The most commonly used treatment option is surgery, and this is often done laparoscopically [4].…”

Section: Introductionmentioning

confidence: 99%

Other Pathologies Were Rarely Reported after Laparoscopic Surgery for Suspected Appendicitis: A Systematic Review and Meta-Analysis

Henriksen¹,

Rosenberg²,

Fonnes³

2023

Dig Surg

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Background: Diagnostic laparoscopy is often used when a patient is suspected of having acute appendicitis. The aim of this study was to assess the rate of other pathologies found during diagnostic laparoscopy for suspected acute appendicitis. Methods: This systematic search included studies with ≥100 patients who received laparoscopy for suspected acute appendicitis and reported on the histopathologic and other intra-abdominal findings. We performed a meta-analysis estimating the rate of other pathologies, and a sensitivity analysis excluding smaller cohorts (≤500 patients). Age groups, sex, specific findings, and geographic regions were investigated. Certainty of evidence was assessed with GRADE. Results: A total of 27 studies were included covering 25,547 patients and of these 793 had an unexpected pathology. The findings were benign pathology in the appendix (34%), malignancy (30%), gynecologic pathology (5%), gastrointestinal pathology (4%), or unspecified (27%). Meta-analysis showed an overall rate of unexpected findings of 3.5% (95% CI 2.7–4.3; moderate certainty), and the sensitivity analysis showed similar results. Malignancy found in the appendix when treating suspected acute appendicitis was 1.0% (95% CI 0.8–1.3%; high certainty). Conclusion: The rate of other histopathological findings in patients with suspected acute appendicitis was low and a malignancy in appendix was found in 1% of patients.

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The use of computed tomography versus clinical acumen in diagnosing appendicitis in children: A two-institution international study

Cited by 11 publications

References 32 publications

WITHDRAWN: Diagnostic value of ultrasonography and computed tomography in pathology-confirmed acute appendicitis in children

WITHDRAWN: Diagnostic value of ultrasonography and computed tomography in pathology-confirmed acute appendicitis in children

NETworking for Health and in Disease: Neutrophil Extracellular Traps in Pediatric Surgical Care

Other Pathologies Were Rarely Reported after Laparoscopic Surgery for Suspected Appendicitis: A Systematic Review and Meta-Analysis

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