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Ultrasound features of secondary appendicitis in pediatric patients

PURPOSE: The purpose of this study was to evaluate the ultrasonographic findings of secondary appendicitis (SA) and to discuss the differential findings compared with primary appendicitis. METHODS: In this study, we analyzed the ultrasonographic findings of 94 patients under 15 years old of age trea...

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Autores principales: Kwon, Lyo Min, Lee, Kwanseop, Min, Soo Kee, Ahn, Soo Min, Ha, Hong Il, Kim, Min-Jeong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Ultrasound in Medicine 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6044217/
https://www.ncbi.nlm.nih.gov/pubmed/29141286
http://dx.doi.org/10.14366/usg.17029
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author Kwon, Lyo Min
Lee, Kwanseop
Min, Soo Kee
Ahn, Soo Min
Ha, Hong Il
Kim, Min-Jeong
author_facet Kwon, Lyo Min
Lee, Kwanseop
Min, Soo Kee
Ahn, Soo Min
Ha, Hong Il
Kim, Min-Jeong
author_sort Kwon, Lyo Min
collection PubMed
description PURPOSE: The purpose of this study was to evaluate the ultrasonographic findings of secondary appendicitis (SA) and to discuss the differential findings compared with primary appendicitis. METHODS: In this study, we analyzed the ultrasonographic findings of 94 patients under 15 years old of age treated at our institution from May 2005 to May 2014 who had bowel inflammation and an inflamed appendix with a maximal outer diameter >6 mm that improved with nonsurgical treatment (the SA group). Ninety-nine patients with pathologically proven acute appendicitis (the primary appendicitis [PA] group) from June 2013 to May 2014 and 44 patients with pathologically negative appendectomy results from May 2005 to May 2014 were also included to compare the ultrasonographic features of these conditions. A retrospective review of the ultrasonographic findings was performed by two radiologists. The clinical and laboratory findings were also reviewed. The results were statically analyzed using analysis of variance, the Pearson chi-square test, and the two-tailed Fisher exact test. RESULTS: Compared with PA, cases of SA had a smaller diameter (9.8 mm vs. 6.6 mm, P<0.001), and were less likely to show periappendiceal fat inflammation (98% vs. 6%, P<0.001) or an appendicolith (34% vs. 11%, P<0.001). SA showed mural hyperemia on color Doppler ultrasonography as frequently as PA (P=0.887). CONCLUSION: The ultrasonographic features of SA included an increased diameter compared to a healthy appendix and the same level of hyperemia as in PA. However, the diameter was commonly in the equivocal range (mean diameter, 6.6 mm), and periappendiceal fat inflammation was rarely present in SA.
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spelling pubmed-60442172018-07-18 Ultrasound features of secondary appendicitis in pediatric patients Kwon, Lyo Min Lee, Kwanseop Min, Soo Kee Ahn, Soo Min Ha, Hong Il Kim, Min-Jeong Ultrasonography Original Article PURPOSE: The purpose of this study was to evaluate the ultrasonographic findings of secondary appendicitis (SA) and to discuss the differential findings compared with primary appendicitis. METHODS: In this study, we analyzed the ultrasonographic findings of 94 patients under 15 years old of age treated at our institution from May 2005 to May 2014 who had bowel inflammation and an inflamed appendix with a maximal outer diameter >6 mm that improved with nonsurgical treatment (the SA group). Ninety-nine patients with pathologically proven acute appendicitis (the primary appendicitis [PA] group) from June 2013 to May 2014 and 44 patients with pathologically negative appendectomy results from May 2005 to May 2014 were also included to compare the ultrasonographic features of these conditions. A retrospective review of the ultrasonographic findings was performed by two radiologists. The clinical and laboratory findings were also reviewed. The results were statically analyzed using analysis of variance, the Pearson chi-square test, and the two-tailed Fisher exact test. RESULTS: Compared with PA, cases of SA had a smaller diameter (9.8 mm vs. 6.6 mm, P<0.001), and were less likely to show periappendiceal fat inflammation (98% vs. 6%, P<0.001) or an appendicolith (34% vs. 11%, P<0.001). SA showed mural hyperemia on color Doppler ultrasonography as frequently as PA (P=0.887). CONCLUSION: The ultrasonographic features of SA included an increased diameter compared to a healthy appendix and the same level of hyperemia as in PA. However, the diameter was commonly in the equivocal range (mean diameter, 6.6 mm), and periappendiceal fat inflammation was rarely present in SA. Korean Society of Ultrasound in Medicine 2018-07 2017-08-25 /pmc/articles/PMC6044217/ /pubmed/29141286 http://dx.doi.org/10.14366/usg.17029 Text en Copyright © 2018 Korean Society of Ultrasound in Medicine (KSUM) This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kwon, Lyo Min
Lee, Kwanseop
Min, Soo Kee
Ahn, Soo Min
Ha, Hong Il
Kim, Min-Jeong
Ultrasound features of secondary appendicitis in pediatric patients
title Ultrasound features of secondary appendicitis in pediatric patients
title_full Ultrasound features of secondary appendicitis in pediatric patients
title_fullStr Ultrasound features of secondary appendicitis in pediatric patients
title_full_unstemmed Ultrasound features of secondary appendicitis in pediatric patients
title_short Ultrasound features of secondary appendicitis in pediatric patients
title_sort ultrasound features of secondary appendicitis in pediatric patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6044217/
https://www.ncbi.nlm.nih.gov/pubmed/29141286
http://dx.doi.org/10.14366/usg.17029
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