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US as a Primary Diagnostic Tool in Relation to Negative Appendectomy: Six Years Experience¹

¹ From the Departments of Radiology (S.P., M.H., M.P.) and Surgery (W.R., K.P.), University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria; and St Anna Children’s Hospital, Vienna, Austria (R.F.P.). From the 2001 RSNA scientific assembly. Received October 3, 2001; revision requested December 11; final revision received April 22, 2002; accepted May 24. Address correspondence to S.P. (e-mail: stefan.puig@univie.ac.at).

PURPOSE: To evaluate the effect of ultrasonography (US) on the rate of appendectomy after false-positive diagnosis of acute appendicitis (negative appendectomy).

MATERIALS AND METHODS: Data were analyzed in 736 pediatric patients (mean age, 13.2 years) who had undergone appendectomy between 1995 and 2000. Histologic data were compared in patients who underwent US with those who did not undergo imaging prior to surgery. US was performed by a radiologist or a pediatric surgeon or both.

RESULTS: A total of 643 (87.4%) of the 736 pediatric patients underwent preoperative US, and 93 (12.6%) of the 736 did not undergo preoperative US. Of the 736 patients, 97 (13.2%) underwent negative appendectomy. Thirty-four (36.6%) of the 93 patients who underwent appendectomy with no preoperative US and 63 (9.8%) of the 643 patients who underwent preoperative US underwent negative appendectomy. There was a significant association between US and positive appendectomy (P < .001).

CONCLUSION: US in pediatric patients suspected of having appendicitis can significantly lower the negative appendectomy rate.

© RSNA, 2002

Index terms: Appendicitis, 751.291 • Appendix, US, 751.12981

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