OBJECTIVES: To determine the accuracy of sonography in the diagnosis of clinically equivocal @entity698 , and to identify the factors leading to an inaccurate ultrasound diagnosis. The impact of sonographic findings on clinical management and outcome of @entity1 with @entity698 is examined. METHODS: We performed a retrospective review of 317 @entity1 who attended the emergency department (ED) of a @entity1 's hospital for acute @entity490 for which @entity697 was the main differential diagnosis. They had ultrasound because the diagnosis was uncertain clinically. RESULTS: The positive predictive value of ultrasound for @entity698 was 0.92, and the negative predictive value was 0.88. The sensitivity and specificity could not be determined because there were 43 @entity1 with equivocal ultrasound results. The pitfalls hindering the accuracy of ultrasound diagnosis included a high incidence of @entity698 at presentation, the retrocecal appendix, and other technical factors such as abdominal guarding, excessive @entity29 , @entity28 , inadequate @entity1494 , and the uncooperative @entity1 . When ultrasound findings were combined with clinical judgment in clinical management, there were only five cases of non-therapeutic laparotomy and eight cases of delayed surgery due to missed diagnosis in our cohort. CONCLUSIONS: Ultrasound is a useful for the evaluation of acute @entity490 in @entity1 . However, in the setting of a pediatric hospital ED, the accuracy of ultrasound and its ability to improve early hospital triage may be reduced. Repeated clinical review is still essential and in selected cases, appendiceal CT scan may be required to guide therapeutic decision making.

XXXX in "real-time": the value of sonography in diagnosis and treatment.

@entity1 :: ('9606', 'Species') :: ['children', 'patients', 'patient'] @entity697 :: ('MESH:D000208', 'Disease') :: ['acute appendicitis'] @entity698 :: ('MESH:D001064', 'Disease') :: ['perforated appendicitis', 'appendicitis'] @entity28 :: ('MESH:D009765', 'Disease') :: ['obesity'] @entity1494 :: ('MESH:D001745', 'Disease') :: ['bladder filling'] @entity29 :: ('MESH:D015212', 'Disease') :: ['bowel gas'] @entity490 :: ('MESH:D015746', 'Disease') :: ['abdominal pain']
@entity698 :: (MESH:D001064,Disease) :: ['Pediatric appendicitis']
