Uppal Ravi, Muntean Cornelia, Raio Christopher, Borowski Halina, Kalin Cameron, Emanuel Jillian, Klein Lauren R
Emergency Medicine, Good Samaritan University Hospital, West Islip, USA.
Cureus. 2025 Apr 23;17(4):e82854. doi: 10.7759/cureus.82854. eCollection 2025 Apr.
Background Ultrasound has emerged as the preferred initial imaging modality for diagnosing acute appendicitis in children, but most data supporting its use come from academic children's medical centers. The purpose of this investigation is to describe ultrasound utilization for diagnosing acute appendicitis in children at a large community hospital network. Methods This was a multicenter retrospective observational cohort study and chart review of pediatric patients with acute appendicitis diagnosed in the emergency department (ED). The primary outcome of this study was the proportion of patients diagnosed with ultrasound as the sole imaging modality, presented as a population proportion with a 95% confidence interval. Results There were 450 patients included. The mean age was 10 years (range 3-17). Among the 450 patients, there were a total of 713 imaging studies. Only 213 (47.3%) patients had a single imaging test ordered during the ED encounter, and only 52 patients (11.6%) had an ultrasound during the encounter as the only imaging modality. The initial study ordered was a CT scan in 184 (40.9%), an ultrasound in 172 (38.2%), and an X-ray in 94 (20.9%). Sixty-two of 172 (36.0%) ultrasounds were positive for appendicitis. Of the 62 positive studies, 11 (17.7%) had a confirmatory CT scan. Conclusion In this community hospital network, patients had multiple imaging modalities ordered to confirm the diagnosis of acute appendicitis. Less than half had an ultrasound ordered as the initial imaging modality, suggesting its use is not as widespread as academic data may indicate. Despite a positive diagnostic ultrasound, some patients went on to have a confirmatory CT scan, which provides further opportunity to improve.
超声已成为诊断儿童急性阑尾炎的首选初始成像方式，但支持其使用的大多数数据来自学术性儿童医疗中心。本调查的目的是描述在一个大型社区医院网络中超声在诊断儿童急性阑尾炎方面的应用情况。方法：这是一项多中心回顾性观察队列研究，对在急诊科诊断为急性阑尾炎的儿科患者进行病历审查。本研究的主要结局是被诊断为仅使用超声作为唯一成像方式的患者比例，以具有95%置信区间的总体比例表示。结果：共纳入450例患者。平均年龄为10岁（范围3 - 17岁）。在这450例患者中，总共进行了713次成像检查。在急诊科就诊期间，只有213例（47.3%）患者进行了单次成像检查，只有52例（11.6%）患者在就诊期间将超声作为唯一的成像方式。最初开具的检查中，184例（40.9%）为CT扫描，172例（38.2%）为超声，94例（20.9%）为X线检查。172例超声检查中有62例（36.0%）阑尾超声检查呈阳性。在这62例阳性检查中，11例（17.7%）进行了CT扫描以确诊。结论：在这个社区医院网络中，患者进行了多种成像方式检查以确诊急性阑尾炎。不到一半的患者最初开具的成像检查是超声，这表明其使用并不像学术数据所显示的那样广泛。尽管超声诊断呈阳性，但一些患者仍继续进行CT扫描以确诊，这提供了进一步改进的机会。
