Featured Research

from universities, journals, and other organizations

Ultrasound diagnoses appendicitis without X-rays

Date:
December 24, 2012
Source:
Washington University in St. Louis
Summary:
Children suspected of having appendicitis are more likely to receive CT scans, which involve radiation, if they are evaluated at a general hospital, a new study has shown.

Colored areas on the appendix (whose tip is marked by the yellow arrow) indicate increased blood flow, a sign of the inflammation that characterizes appendicitis. This data helps doctors decide if surgery to remove the appendix is necessary.
Credit: Image courtesy of Washington University in St. Louis

Children suspected of having appendicitis are more likely to receive CT scans, which involve radiation, if they are evaluated at a general hospital, a new study by Washington University School of Medicine in St. Louis has shown.

Related Articles


Similar patients who went to St. Louis Children's Hospital were more often evaluated with an ultrasound scan, a safer option that uses sound waves instead of radiation to confirm or rule out the need for surgery to remove the appendix.

Use of either scanning technique can potentially reduce the occurrence of unnecessary surgeries and expedite the diagnosis of appendicitis. But recent reports have suggested that the radiation exposures in CT scans can significantly increase children's lifetime cancer risk. As a result, researchers are reassessing the role of CT scans and seeking ways to reduce their use.

The study appears online Dec. 24 in the journal Pediatrics.

"Appendicitis is a very tough diagnosis, because its symptoms overlap with viral infections and other problems," says first author Jacqueline Saito, MD, assistant professor of surgery. "We don't want to operate when the appendix is fine, but if we wait too long, an inflamed appendix can rupture or perforate, making recovery more complicated and much slower."

The appendix is a finger-shaped pouch that extends from the large intestine. Infection or blockage of the appendix causes appendicitis, which can lead to abdominal pain, vomiting and fever.

Saito and her colleagues analyzed case records of 423 children who had appendectomies, or surgery to remove the appendix, at St. Louis Children's Hospital. In 218 patients initially evaluated at Children's Hospital and 205 at general hospitals, researchers reviewed how the patients were evaluated for appendicitis and whether the surgery's results confirmed the diagnosis.

CT scans, which take X-ray images from multiple angles, have been the primary diagnostic scan for detecting appendicitis for many years. About 85 percent of children initially evaluated at a general hospital underwent preoperative CT scans, and 45 percent of children initially seen at St. Louis Children's Hospital had CT scans. Using ultrasound to detect appendicitis has recently become more frequent, especially at St. Louis Children's Hospital; over half of children initially seen at St. Louis Children's Hospital, compared to 20 percent at general hospitals, had preoperative ultrasound.

Only 7 percent were not scanned using either method, and 15 percent had both types of imaging.

While ultrasound scans are safer for diagnosing appendicitis in children, they must be performed and interpreted by personnel who have received specialized training and are familiar with pediatric diagnostics.

"Ultrasound scans are difficult to perform correctly in this context, and what specialists can do at Children's Hospital may not be realistic or even available in a general hospital, which doesn't care for children as often," Saito says.

Saito is currently studying the outcomes of patients whose scans ruled out an appendectomy, looking to see if they had any additional symptoms or eventually had to have their appendixes removed.

"Ultimately what we'd liked to do is learn how we can reduce our use of CT imaging without compromising patient care," she says. "We want to find ways to identify the patients who really need these scans and those who can be effectively evaluated using other methods."

Funding from the National Center for Research Resources (award number UL1RR024992) and the St. Louis Children's Hospital Children's Hospital Children's Surgical Sciences Institute.


Story Source:

The above story is based on materials provided by Washington University in St. Louis. The original article was written by Michael C. Purdy. Note: Materials may be edited for content and length.


Journal Reference:

  1. Jacqueline M. Saito, Yan Yan, Thomas W. Evashwick, Brad W. Warner, Phillip I. Tarr. Use and Accuracy of Diagnostic Imaging by Hospital Type in Pediatric Appendicitis. Pediatrics, 2012; [link]

Cite This Page:

Washington University in St. Louis. "Ultrasound diagnoses appendicitis without X-rays." ScienceDaily. ScienceDaily, 24 December 2012. <www.sciencedaily.com/releases/2012/12/121224113349.htm>.
Washington University in St. Louis. (2012, December 24). Ultrasound diagnoses appendicitis without X-rays. ScienceDaily. Retrieved January 31, 2015 from www.sciencedaily.com/releases/2012/12/121224113349.htm
Washington University in St. Louis. "Ultrasound diagnoses appendicitis without X-rays." ScienceDaily. www.sciencedaily.com/releases/2012/12/121224113349.htm (accessed January 31, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Saturday, January 31, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

CDC: Get Vaccinated for Measles

CDC: Get Vaccinated for Measles

Reuters - US Online Video (Jan. 30, 2015) The CDC is urging people to get vaccinated for measles amid an outbreak that began at Disneyland and has now infected more than 90 people. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
Obama To Outline New Plan For Personalized Medicine

Obama To Outline New Plan For Personalized Medicine

Newsy (Jan. 30, 2015) President Obama is expected to speak with drugmakers Friday about his Precision Medicine Initiative first introduced last week. Video provided by Newsy
Powered by NewsLook.com
NFL Concussions Down; Still on Parents' Minds

NFL Concussions Down; Still on Parents' Minds

AP (Jan. 30, 2015) The NFL announced this week that the number of game concussions dropped by a quarter over last season. Still, the dangers of the sport still weigh on players, and parents&apos; minds. (Jan. 30) Video provided by AP
Powered by NewsLook.com
U.S. Wants to Analyze DNA from 1 Million People

U.S. Wants to Analyze DNA from 1 Million People

Reuters - US Online Video (Jan. 30, 2015) The U.S. has proposed analyzing genetic information from more than 1 million American volunteers to learn how genetic variants affect health and disease. Rough Cut (no reporter narration). Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins