Ultrasound in pediatric patients with suspected acute appendicitis: Value in establishing alternative diagnoses

The objective of this study was to investigate the value of ultrasound to establish alternative diagnoses in pediatric patients with clinical suspicion of acute appendicitis. A total of 206 consecutive patients with right lower abdominal pain were evaluated by ultrasound. For each case, the sonographic findings documented on the report at the time of examination were compared with the final diagnosis.Our results demonstrated that ultrasound was 94% accurate in the diagnosis of acute appendicitis. Among all 42 of the 108 truenegative cases of appendicitis, there was a variety of sonographic findings other than appendiceal abnormality, comprising intestinal and/or mesenteric, gallbladder, and ovarian abnormalities. Sonographic findings were well correlated with clinical and/or surgical diagnoses. Only 3 of these 42 cases were treated by surgical intervention.Ultrasound of pediatric right lower abdominal pain is a reliable diagnostic tool not only for appendicitis but for alternative diagnoses mimicking appendicitis.