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CT of appendicitis in children.

Abstract：

PURPOSE:Our goal was to review the CT findings and to help define the role of CT in the evaluation of appendicitis in children. METHOD:Of 730 children with surgically proven appendicitis, 22 underwent preoperative CT evaluation. Their CT scans and operative and pathology records were retrospectively reviewed. The CT scans were evaluated for appendiceal wall thickness, diameter, and location, appendicoliths, pericecal inflammation, phlegmon, abscess, free fluid, small bowel dilatation, and bowel wall thickening. Criteria for diagnosing appendicitis were (a) appendiceal wall thickening (> 1 mm) or (b) presence of abscess, phlegmon, or pericecal inflammation associated with appendicolith(s). Prospective reports of ultrasound examinations performed within 2 days of the CT scans were available in 14 children and were correlated with the CT findings. RESULTS:An abnormally thickened appendix, with a diameter ranging from 9 to 18 mm, was seen in four children. Three appendices were retrocecal and one was near the cecal tip, anterior to the iliac vessels. Appendicoliths were present in 10 children, multiple in 1. Abscesses were seen in 13 of 22 children, multiple in 5. Phlegmon was seen in five children and pericecal inflammation in two. Bowel wall thickening was present in seven children and small bowel dilatation was noted in six. Other findings included free fluid, hydronephrosis, thickening of urinary bladder wall, air in the uterus and vagina, adenopathy, and thickening of the abdominal wall musculature. CT was diagnostic of appendicitis in 11 of 22 children (50%). In 14 children with both ultrasound and CT studies, CT was slightly better in diagnosing appendicitis and visualizing the abnormal appendix and was superior in defining the presence and extent of abscess and inflammation in 9 of 14 children. CONCLUSION:CT is a useful adjunct in diagnosing appendicitis in children, with a major role in cases of complicated appendicitis.

journal_name

J Comput Assist Tomogr

journal_title

Journal of computer assisted tomography

authors

Jabra AA,Shalaby-Rana EI,Fishman EK

doi

10.1097/00004728-199707000-00028

subject

Has Abstract

pub_date

1997-07-01 00:00:00

pages

661-6

issue

eissn

0363-8715

issn

1532-3145

journal_volume

pub_type

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CT of appendicitis in children.