ArticleJournal of pediatric surgery2016
Secondary signs may improve the diagnostic accuracy of equivocal ultrasounds for suspected appendicitis in children.
Article in Journal of pediatric surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Swedish national guidelines for diagnosis and management of acute appendicitis in adults and children.BJS open · 2025Guideline
- The utility of sonographic signs to diagnose simple and complicated appendicitis in children.Pediatric surgery international · 2023Article
- Clinical course in children with equivocal appendicitis on computed tomography: a retrospective cohort study.Annals of surgical treatment and research · 2023Article
- The utility of spectral Doppler evaluation of acute appendicitis.Emergency radiology · 2022Article
- Diagnostic performance of standardized ultrasound protocol for detecting perforation in pediatric appendicitis.Pediatric radiology · 2019Article
- To determine validity of ultrasound in predicting acute appendicitis among children keeping histopathology as gold standard.Annals of medicine and surgery (2012) · 2019Article
- Falling through the worm hole: an exploration of the imaging workup of the vermiform appendix in the pediatric population.BJR open · 2019Review
- Improving the value of ultrasound in children with suspected appendicitis: a prospective study integrating secondary sonographic signs.Ultrasonography (Seoul, Korea) · 2019Article
- Article
- What Does the Future Hold for Scientific Journals? Visual Abstracts and Other Tools for Communicating Research.Clinics in colon and rectal surgery · 2017Review
- Improving ultrasound for appendicitis through standardized reporting of secondary signs.Journal of pediatric surgery · 2017Article
- Ultrasonography-triggered diagnosis of putrid, ulcero-phlegmonous, hemorrhagic appendicitis and periappendicitis with an atypical symptom pattern: a case report.Military Medical Research · 2016Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
introductionUltrasound (US) is the preferred imaging modality for evaluating appendicitis. Our purpose was to determine if including secondary signs (SS) improve diagnostic accuracy in equivocal US studies.
methodsRetrospective review identified 825 children presenting with concern for appendicitis and with a right lower quadrant (RLQ) US. Regression models identified which SS were associated with appendicitis. Test characteristics were demonstrated.
results530 patients (64%) had equivocal US reports. Of 114 (22%) patients with equivocal US undergoing CT, those with SS were more likely to have appendicitis (48.6% vs 14.6%, p<0.001). Of 172 (32%) patients with equivocal US admitted for observation, those with SS were more likely to have appendicitis (61.0% vs 33.6%, p<0.001). SS associated with appendicitis included fluid collection (adjusted odds ratio (OR) 13.3, 95% confidence interval (CI) 2.1-82.8), hyperemia (OR=2.0, 95%CI 1.5-95.5), free fluid (OR=9.8, 95%CI 3.8-25.4), and appendicolith (OR=7.9, 95%CI 1.7-37.2). Wall thickness, bowel peristalsis, and echogenic fat were not associated with appendicitis. Equivocal US that included hyperemia, a fluid collection, or an appendicolith had 96% specificity and 88% accuracy.
conclusionUse of SS in RLQ US assists in the diagnostic accuracy of appendicitis. SS may guide clinicians and reduce unnecessary CT and admissions.
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Registered trials
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