Correlating Abdominal Wall Thickness and Body Mass Index to Predict Usefulness of Right Lower Quadrant Ultrasound for Evaluation of Pediatric Appendicitis

Conclusions While the BMI cutoff standard of less than 25 kg/m2 for usefulness of appendix US holds in the adult population, our data expand the acceptable range in children younger than 9 years regardless of BMI and male children with BMI up to 30 kg/m2. Female children younger than 15 years with a BMI up to 30 kg/m2 may also be amenable to right lower quadrant US based on AWT. These parameters inform selective and efficient use of US for appendix evaluation.
Source: Pediatric Emergency Care - Category: Emergency Medicine Tags: Original Articles Source Type: research

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Medical imaging saves millions of lives each year, helping doctors detect and diagnose a wide range of diseases, from cancer and appendicitis to stroke and heart disease. Because non-invasive early disease detection saves so many lives, scientific investment continues to increase. Artifical intelligence (AI) has the potential to revolutionize the medical imaging industry by sifting through mountains of scans quickly and offering providers and patients with life-changing insights into a variety of diseases, injuries, and conditions that may be hard to detect without the supplemental technology. Images are the largest source...
Source: MDDI - Category: Medical Devices Authors: Tags: Imaging Source Type: news
Conclusions Computed tomography scans were performed in 13.9% of patients with suspected AP. The overall AP rate was 28.4%. We plan to increase the use of magnetic resonance imaging and other modalities to reduce overall computed tomography usage.
Source: Pediatric Emergency Care - Category: Emergency Medicine Tags: Original Research-QI Source Type: research
Abstract Point-of-care ultrasonography (POCUS) is performed by a physician at the bedside and is standard practice in obstetric, emergency, and musculoskeletal medicine. When compared with formal sonography, POCUS is equivalent in screening for abdominal aortic aneurysm and as accurate in diagnosing deep venous thrombosis. POCUS has high accuracy for diagnosing pneumonia and detecting acute decompensated heart failure but is less accurate than computed tomography for identifying pulmonary embolism. POCUS confirmation of intrauterine pregnancy rules out an ectopic pregnancy. In the third trimester of high-risk preg...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research
CONCLUSION: The strategy of repeating limited focused US followed by CT scan in cases that remain inconclusive has good diagnostic accuracy and reasonable NAR and decreases the number of CT scans. PMID: 31913249 [PubMed - as supplied by publisher]
Source: Pain Physician - Category: Anesthesiology Authors: Tags: Pediatr Emerg Care Source Type: research
(Aust N Z J Obstet Gynaecol. 2019;59:45–53) The most common emergency nonobstetric abdominal surgery performed in parturients is appendicectomy, which occurs in ∼0.3% of pregnancies. Establishing the diagnosis of appendicitis is more challenging in pregnant women as a result of the physiological changes of pregnancy and the many non-specific symptoms experienced during normal pregnancy. In addition, the use of ultrasound to make the diagnosis is less effective due to the presence of the gravid uterus and computed tomography scanning is sometimes avoided to prevent fetal radiation exposure. Appendiceal perforatio...
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Epidemiologic Reports Surveys Source Type: research
Children with suspected appendicitis generally undergo an ultrasound (most commonly) or a CT scan (rarely) as the first imaging study. At our hospital, patients with non-diagnostic ultrasound or CT scan results undergo a non-contrast (unenhanced), non-sedated MRI. We aimed to determine the accuracy of this study for this purpose in a large cohort of children.
Source: Journal of Pediatric Surgery - Category: Surgery Authors: Source Type: research
The purpose of this study is to review the cases of postcolonoscopy appendicitis (PCA) reported in the literature. A comprehensive search using PubMed, EMBASE, Scopus, and Google Scholar identified 57 cases. The median age at presentations of PCA was 55 years. PCAs typically occurred during the first 24 hours after colonoscopy, and the majority developed after diagnostic colonoscopy. Clinical presentations were similar to those with common acute appendicitis, though with a high perforation rate. Most patients were correctly diagnosed using ultrasound or computed tomography scan. Treatment included open appendicectomy, lapa...
Source: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques - Category: Surgery Tags: Review Articles Source Type: research
Conclusion: Macroscopic identification intraoperatively is inaccurate with a FN rate of 22%.
Source: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques - Category: Surgery Tags: Original Articles Source Type: research
Authors: Altomare M, Cimbanassi S, Chiara O, Salvi PF Abstract OBJECTIVES: Evaluate Alvarado Score's (AS) accuracy related with C-reactive protein (CRP). Evaluate the accuracy rate of ultrasonography (US). MATERIALS AND METHODS: We analyzed data on 290 patients admitted to Emergency Department (ED) of Sant'Andrea Hospital (Rome - Italy) presenting abdominal pain in lower quadrants between Jan2009-Apr2015. AS, laboratory tests, images and report from CT-scan and US were collected. Histological examination is considered as Gold Standard. We calculated Specificity(Sp), Sensitivity(Se), Accuracy(Ac), positive predi...
Source: Annali Italiani di Chirurgia - Category: Surgery Tags: Ann Ital Chir Source Type: research
The presentation of appendicitis in pediatrics is variable, and diagnostic imaging is often used. Magnetic resonance imaging (MRI) is replacing computed tomography in some centers, particularly after a nondiagnostic ultrasound (NDUS). Nonetheless, MRI is not widely used in this setting because of cost, procedure time, institutional capacity, and high rates of negative scans. We hypothesized that the Alvarado Score (AS) could be used to determine the additive diagnostic value of MRI after an NDUS.
Source: Journal of Surgical Research - Category: Surgery Authors: Tags: Pediatric/Congenital/Developmental Source Type: research
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