Pediatr Surg Int (2017) 33:1007–1012 DOI 10.1007/s00383-017-4121-4 ORIGINAL ARTICLE Creating diagnostic criteria for perforated appendicitis using cross-sectional imaging 1 2 3 4 • • • • Joseph T. Church Megan A. Coughlin Alexis G. Antunez Ethan A. Smith Steven W. Bruch Accepted: 27 June 2017 / Published online: 3 July 2017 Springer-Verlag GmbH Germany 2017 Abstract speciﬁc, compared to 68.4% (p = 0.19) and 92.4% Introduction Preoperative determination of perforated (p = 0.025) for CT. WBC [ 15, temperature [38.0 C, versus acute appendicitis can be difﬁcult. We compared CT and peritoneal signs predicted perforation. Diagnostic and MRI performance in diagnosing perforated appen- accuracy of MRI was highest using imaging ﬁndings alone. dicitis, and created diagnostic criteria. Accuracy of CT was improved by mandating at least one of Methods We retrospectively reviewed all pediatric patients the previous three clinical correlates, resulting in 68.4% who underwent appendectomy within one day of CT or sensitivity and 93.9% speciﬁcity. MRI between 1/1/2013 and 1/16/2016. True diagnosis was Conclusions MRI trended toward more sensitive and CT determined by pathology report. Findings on CT/MRI were was more speciﬁc for complicated appendicitis. CT grouped into ‘‘hard’’ ﬁndings (abscess, pneumoperitoneum, speciﬁcity is improved by our algorithm.
Pediatric Surgery International – Springer Journals
Published: Jul 3, 2017
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