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Suspected Appendicitis in Children: US and CT— A Prospective Randomized Study¹

¹ From the Departments of Pediatric Radiology (S.K., H.K.J.) and Pediatric Surgery (B.F.), Astrid Lindgren Children’s Hospital, Karolinska Institute, SE-171 76 Stockholm, Sweden. Received June 20, 2001; revision requested July 9; revision received September 24; accepted November 12. Supported by grants from the Crown Princess Lovisa’s Association for Children’s Health Care and the Axel Tielman Foundation. Address correspondence to S.K. (e-mail: sylvie.kaiser@ks.se).

View larger version (16K): [in a new window]   Figure 1. Flow diagram of patients suspected of having appendicitis. Non-op = nonsurgically treated patients, Op = surgically treated patients.

View larger version (107K): [in a new window]   Figure 2. Transverse contrast agent-enhanced abdominal CT scan demonstrates an inflamed appendix (1) with a diameter of 8 mm and an appendicolith (2).

View larger version (96K): [in a new window]   Figure 3. Transverse contrast-enhanced abdominal CT scan demonstrates an enlarged retrocecal appendix (1) with a diameter of 14 mm.

View larger version (21K): [in a new window]   Figure 4. Correct diagnoses correlated with radiologic findings. Light gray bars = patients with a correct diagnosis, diagonally hatched bars = patients with false-negative findings, cross-hatched bars = patients with false-positive findings, black bars = patients with true-negative findings, dark gray bars = patients with true-positive findings.

View larger version (17K): [in a new window]   Figure 5a. Outcome results in (a) surgically and (b) nonsurgically treated patients. A = appendicitis, AA = appendiceal abscess, AP = nonspecific abdominal pain, G = gastroenteritis, M = miscellaneous abnormality, ML = mesenterial lymphadenitis, NA = negative appendectomy, OC = ovarian cyst, OD = other diagnosis, P = pneumonia, UI = urinary tract infection.

View larger version (22K): [in a new window]   Figure 5b. Outcome results in (a) surgically and (b) nonsurgically treated patients. A = appendicitis, AA = appendiceal abscess, AP = nonspecific abdominal pain, G = gastroenteritis, M = miscellaneous abnormality, ML = mesenterial lymphadenitis, NA = negative appendectomy, OC = ovarian cyst, OD = other diagnosis, P = pneumonia, UI = urinary tract infection.