Re-Appraising the Role of Sonography in Pediatric Acute Abdominal Pain

OBJECTIVE: Most pediatric emergency department (ED) visits are due to acute abdominal pain. Sonography is a reliable technique for differential diagnosis. The objective of this study was to re-appraise the role of sonography in evaluating acute abdominal pain in children. METHODS: Retrospective chart review of children aged <18 years with acute abdominal pain who visited the emergency department and underwent sonography between December 2004 and June 2006 was conducted. Patients with trauma were excluded. FINDINGS: 775 patients (478 males and 297 females, age 1-17 years; mean age 6±5.8 years) enrolled the study. Among 284 children with suspected appendicitis, 118 were diagnosed with appendicitis using sonography. Of 663 children without appendicitis, majority had gastrointestinal tract infection or non-specific abdominal pain. Other specific diagnoses were established by clinical, laboratory, and radiologic finings in 51 patients (including renal diseases in 20, intussusceptions in 15, gynecologic diseases in six, extra-abdominal disease in 4, and gastrointestinal tract abnormalities in 2). The sensitivity and specificity of sonography was 96.4% and 76.7%, respectively, for diagnosing appendicitis and 100% and 100%, respectively, for intussusception. CONCLUSION: Sonography remains a very effective, complementary, non-invasive method for evaluating children with acute abdominal pain, especially those with suspected appendicitis or intussusception.