Clinical course in children with equivocal appendicitis on computed tomography : a retrospective cohort study
Copyright © 2023, the Korean Surgical Society..
Purpose: Appendectomy is one of the most common surgeries in children. Although various radiological examinations are performed, they do not always reveal a definitive diagnosis of appendicitis. This study aimed to investigate the clinical course of equivocal appendicitis, identify the factors associated with appendectomy, and suggest appropriate management for these patients.
Methods: Patients younger than 19 years who visited Seoul National University Bundang Hospital with a differential diagnosis of appendicitis from January 2013 to December 2017 were included. All participants conducted 'appendiceal CT' with a scoring scale of 1-5. The higher the score, the higher the likelihood of a radiologic diagnosis of appendicitis. We defined the appendicitis CT score of 2-4 as equivocal appendicitis (n = 143). Medical records were reviewed retrospectively for demographics, further examination as abdominal ultrasonography, and appendectomy status (yes or no). The mean follow-up period was 15.6 ± 71 days.
Results: Equivocal appendicitis accounted for 16.7%. Additional ultrasonography test was performed in 24.5% (35 of 143). In total, 34 patients (23.8%) underwent appendectomy. Among the patients with appendiceal CT scores 2, 3, and 4, 4.9%, 50.0%, and 87.5% underwent appendectomy, respectively. Higher WBC count, higher appendicitis CT score, and readmission were significantly associated with appendectomy in patients with equivocal appendicitis.
Conclusion: Higher appendicitis CT score and WBC level were positively associated with appendectomy. Careful observation can be a treatment option in appendicitis CT score 2 or 3 groups. Appendectomy is the first-line treatment for patients with appendicitis score 4. Additional ultrasonography test is advisable to determine treatment modality for equivocal appendicitis.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:104 |
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| Enthalten in: |
Annals of surgical treatment and research - 104(2023), 1 vom: 17. Jan., Seite 51-59 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Yang, Hee-Beom [VerfasserIn] |
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| Links: |
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| Themen: |
Appendectomy |
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| Anmerkungen: |
Date Revised 02.02.2023 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.4174/astr.2023.104.1.51 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM351964754 |
|---|
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| 100 | 1 | |a Yang, Hee-Beom |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Clinical course in children with equivocal appendicitis on computed tomography |b a retrospective cohort study |
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| 500 | |a Date Revised 02.02.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright © 2023, the Korean Surgical Society. | ||
| 520 | |a Purpose: Appendectomy is one of the most common surgeries in children. Although various radiological examinations are performed, they do not always reveal a definitive diagnosis of appendicitis. This study aimed to investigate the clinical course of equivocal appendicitis, identify the factors associated with appendectomy, and suggest appropriate management for these patients | ||
| 520 | |a Methods: Patients younger than 19 years who visited Seoul National University Bundang Hospital with a differential diagnosis of appendicitis from January 2013 to December 2017 were included. All participants conducted 'appendiceal CT' with a scoring scale of 1-5. The higher the score, the higher the likelihood of a radiologic diagnosis of appendicitis. We defined the appendicitis CT score of 2-4 as equivocal appendicitis (n = 143). Medical records were reviewed retrospectively for demographics, further examination as abdominal ultrasonography, and appendectomy status (yes or no). The mean follow-up period was 15.6 ± 71 days | ||
| 520 | |a Results: Equivocal appendicitis accounted for 16.7%. Additional ultrasonography test was performed in 24.5% (35 of 143). In total, 34 patients (23.8%) underwent appendectomy. Among the patients with appendiceal CT scores 2, 3, and 4, 4.9%, 50.0%, and 87.5% underwent appendectomy, respectively. Higher WBC count, higher appendicitis CT score, and readmission were significantly associated with appendectomy in patients with equivocal appendicitis | ||
| 520 | |a Conclusion: Higher appendicitis CT score and WBC level were positively associated with appendectomy. Careful observation can be a treatment option in appendicitis CT score 2 or 3 groups. Appendectomy is the first-line treatment for patients with appendicitis score 4. Additional ultrasonography test is advisable to determine treatment modality for equivocal appendicitis | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Appendectomy | |
| 650 | 4 | |a Appendicitis | |
| 650 | 4 | |a Computed tomography | |
| 650 | 4 | |a Pediatrics | |
| 650 | 4 | |a Surgery | |
| 700 | 1 | |a Song, Han-Byol |e verfasserin |4 aut | |
| 700 | 1 | |a Han, Ji-Won |e verfasserin |4 aut | |
| 700 | 1 | |a Youn, Joong Kee |e verfasserin |4 aut | |
| 700 | 1 | |a Ko, Dayoung |e verfasserin |4 aut | |
| 700 | 1 | |a Ryu, Young Jin |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Ji Young |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Hyun-Young |e verfasserin |4 aut | |
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