Evaluation of the ability of laboratory, ultrasonography, and Doppler ultrasonography findings to distinguish between simple and complicated appendicitis.
CRP
Doppler ultrasound
appendicitis
child
ultrasound
Journal
Journal of clinical ultrasound : JCU
ISSN: 1097-0096
Titre abrégé: J Clin Ultrasound
Pays: United States
ID NLM: 0401663
Informations de publication
Date de publication:
06 Sep 2024
06 Sep 2024
Historique:
revised:
07
08
2024
received:
17
05
2024
accepted:
21
08
2024
medline:
6
9
2024
pubmed:
6
9
2024
entrez:
6
9
2024
Statut:
aheadofprint
Résumé
To evaluate the utility of laboratory ultrasonographic and Doppler ultrasonographic findings in the differentiation of simple and complicated appendicitis. A prospective study was conducted, including pediatric patients who underwent surgery with the diagnosis of appendicitis. Fifty patients, who were found to have appendicitis on ultrasonographic examination, were included. The mean age was found to be 12.80 ± 3.67 years, with 30% female and 70% male. The patients were histopathologically divided into two groups: simple appendicitis (Group 1, 41 patients, 82%) and complicated appendicitis (Group 2, 9 patients, 18%). CRP (C-reactive protein) levels (p = 0.004) and periappendiceal fatty tissue thickness (PFI) (p < 0.005) were found to be statistically significantly higher in Group 2 compared to Group 1. The portal vein (PV) diameter and peak systolic velocity (PSV) values were significantly higher in the study group compared to the control group (p = 0.033, p = 0.001). Doppler ultrasonographic examination did not significantly differentiate complicated from simple appendicitis. The CRP value is an independent risk factor in the diagnosis of complicated appendicitis, and the presence of a significant increase in mesenteric tissue thickness is one of the important criteria for differentiating complicated appendicitis from simple appendicitis.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 Wiley Periodicals LLC.
Références
Shen G, Wang J, Fei F, Mao M, Mei Z. Bedside ultrasonography for acute appendicitis: an updated diagnostic meta‐analysis. Int J Surg. 2019;70:1‐9.
Uzunosmanoğlu H, Çevik Y, Çorbacıoğlu ŞK, Akıncı E, Buluş H, Ağladıoğlu K. Diagnostic value of appendicular Doppler ultrasonography in acute appendicitis. Ulus Travma Acil Cerrahi Derg. 2017;23(3):188‐192.
Lee SH, Yun SJ. Diagnostic performance of emergency physician‐performed point‐of‐care ultrasonography for acute appendicitis: a meta‐analysis. Am J Emerg Med. 2019;37(4):696‐705.
Matthew Fields J, Davis J, Alsup C, et al. Accuracy of point‐of‐care ultrasonography for diagnosing acute appendicitis: a systematic review and meta‐analysis. Acad Emerg Med. 2017;24(9):1124‐1136.
Toprak H, Kilincaslan H, Ahmad IC, et al. Integration of ultrasound findings with Alvarado score in children with suspected appendicitis. Pediatr Int. 2014;56(1):95‐99.
Podda M, Gerardi C, Cillara N, et al. Antibiotic treatment and appendectomy for uncomplicated acute appendicitis in adults and children: a systematic review and meta‐analysis. Ann Surg. 2019;270(6):1028‐1040.
Noguchi T, Yoshimitsu K, Yoshida M. Periappendiceal hyperechoic structure on sonography: a sign of severe appendicitis. J Ultrasound Med. 2005;24(3):323‐327; quiz 328–330.
Cameron DB, Anandalwar SP, Graham DA, et al. Development and implications of an evidence‐based and public health‐relevant definition of complicated appendicitis in children. Ann Surg. 2020;271(5):962‐968.
Ahmad T, Khdair Ahmad F, Manson D. Diagnostic performance of a staged pathway for imaging acute appendicitis in children. Pediatr Emerg Care. 2021;37:e1197.
Elbaruni K, Abdulwahed E, Elwafi M, Eljrew M, Atia A. Values of white blood cell count and C‐reactive protein in diagnosis of acute appendicitis. Khalij J Dent Med Res. 2024;8:29‐33.
Ibrahim R, Veeralakshmanan P, Ackah J, Panahi P. Best evidence topic: can acute appendicitis manifest with normal inflammatory markers? Ann Med Surg (Lond). 2020;58:147‐150.
Gonzalez DO, Lawrence AE, Cooper JN, et al. Can ultrasound reliably identify complicated appendicitis in children? J Surg Res. 2018;229:76‐81.
Marin JR, Rodean J, Hall M, et al. Trends in use of advanced imaging in pediatric emergency departments. JAMA Pediatr. 2020;174:e202209.
Baykara AS. Acute appendicitis in children: evaluation of the diagnostic efficacy of ultrasonography and computed tomography. Cureus. 2023;15(8):e43860.
Arruzza E, Milanese S, Li LSK, Dizon J. Diagnostic accuracy of computed tomography and ultrasound for the diagnosis of acute appendicitis: a systematic review and meta‐analysis. Radiography (Lond). 2022;28(4):1127‐1141.
El‐Gohary Y, Molina M, Chang J, et al. The use of computed tomography versus clinical acumen in diagnosing appendicitis in children: a two‐institution international study. J Pediatr Surg. 2021;56:1356‐1361.
Sivit CJ, Applegate KE, Berlin SC, et al. Evaluation of suspected appendicitis in children and young adults: helical CT. Radiology. 2000;216:430‐433.
Incesu L, Yazicioglu AK, Selcuk MB, Ozen N. Contrast‐enhanced power Doppler US in the diagnosis of acute appendicitis. Eur J Radiol. 2004;50(2):201‐209.
Chang ST, Jeffrey RB, Olcott EW. Three‐step sequential positioning algorithm during sonographic evaluation for appendicitis increases appendiceal visualization rate and reduces CT use. AJR Am J Roentgenol. 2014;203(5):1006‐1012.
Blumfield E, Nayak G, Srinivasan R, et al. Ultrasound for differentiation between perforated and nonperforated appendicitis in pediatric patients. AJR Am J Roentgenol. 2013;200:957‐962.
Tong L, Nataraja RM, VanHaltren K, Sulaksana TH, Vinycomb TI, Pacilli M. The utility of sonographic signs to diagnose simple and complicated appendicitis in children. Pediatr Surg Int. 2023;11(39):114.
Goldin AB, Khanna P, Thapa M, et al. Revised ultrasound criteria for appendicitis in children improve diagnostic accuracy. Pediatr Radiol. 2011;41(8):993‐999.
Park NH, Park CS, Lee EJ, et al. Ultrasonographic findings identifying the faecal‐impacted appendix: differential findings with acute appendicitis. Br J Radiol. 2007;80(959):872‐877.
Neal JT, Monuteaux MC, Rangel SJ, Bachur RG, Barnewolt CE. Does age affect the test performance of secondary sonographic findings for pediatric appendicitis? Pediatr Radiol. 2021;51:2018‐2026.
Carpenter JL, Orth RC, Zhang W, Lopez ME, Mangona KL, Guillerman RP. Diagnostic performance of US for differentiating perforated from nonperforated pediatric appendicitis: a prospective cohort study. Radiology. 2017;282(3):835‐841.
Quillin SP, Siegel MJ. Appendicitis: efficacy of color Doppler sonography. Radiology. 1994;191(2):557‐560.
El‐Aleem RA, Abd Allah AA, Shehata MR, Seifeldein GS, Hassanein SM. Diagnostic performance of spectral Doppler in acute appendicitis with an equivocal Alvarado score. Emerg Radiol. 2024;31:141‐149.
Baldisserotto M, Peletti AB. Is colour Doppler sonography a good method to differentiate normal and abnormal appendices in children? Clin Radiol. 2007;62:365‐369.
Martinoli C, Derchi LE, Rizzatto G, Solbiati L. Power Doppler sonography: general principles, clinical applications, and future prospects. Eur Radiol. 1998;8(7):1224‐1235.
Carr NJ. The pathology of acute appendicitis. Ann Diagn Pathol. 2000;4(1):46‐58.
Chan L, Shin LK, Pai RK, Jeffrey RB. Pathologic continuum of acute appendicitis: sonographic findings and clinical management implications. Ultrasound Q. 2011;27(2):71‐79.
Mekakas A, Nagorni E‐A, Tablaridis T. Complicated appendicitis: a surgical controversy concerning risk factors, diagnostic algorithm and therapeutic management. Doubts, Problems, and Certainties about Acute Appendicitis. IntechOpen; 2022.