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. 2021 Jul;37(7):843-849.
doi: 10.1007/s00383-021-04872-8. Epub 2021 Mar 7.

Accuracy of ultrasonography for differentiating between simple and complex appendicitis in children

David J Nijssen  1 , Paul van Amstel  2 , Joost van Schuppen  3 , Laurens D Eeftinck Schattenkerk  2 , Ramon R Gorter  2 , Roel Bakx  2
Affiliations

Accuracy of ultrasonography for differentiating between simple and complex appendicitis in children

David J Nijssen et al. Pediatr Surg Int. 2021 Jul.

Abstract

Purpose: Accurate differentiation between simple and complex appendicitis is important since differences in treatment exist. This study aimed to assess the accuracy of ultrasonography in differentiating between simple and complex appendicitis.

Methods: Data from children aged < 18 years who underwent appendectomy between the 1st of January 2013 and the 1st of January 2018 were analyzed retrospectively. Ultrasonography reports of eligible children were divided into simple (test negative) and complex appendicitis (test positive) based on predefined criteria and compared to a gold standard (a combination of predefined perioperative and histopathological criteria). Sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) were calculated to measure ultrasonographic accuracy in differentiating between simple and complex appendicitis.

Results: 176 children were eligible for inclusion. The mean age at the time of operation was 10.1 ± SD 4.6 years. 84 (47.7%) children had simple appendicitis and 92 (52.3%) had complex appendicitis. The use of ultrasonography yielded a sensitivity: 46%, specificity: 90%, PPV: 84%, and NPV: 60%.

Conclusion: Ultrasonography as standalone modality is not suitable for differentiating between simple and complex appendicitis in children. To improve preoperative differentiation, other variables such as clinical signs and laboratory data are necessary in conjunction with ultrasonography findings.

Keywords: Appendectomy; Appendicitis; Complex appendicitis; Pediatric surgery; Perforated appendicitis; Ultrasonography.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

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