Special Feature: Surgical pediatric surgery cases as seen from imaging
Usefulness of ultrasonography for the diagnosis of pediatric appendicitis
2019 Volume 35 Issue 2 Pages 72-77
Details
2019 Volume 35 Issue 2 Pages 72-77
Acute appendicitis is a common disease that causes acute abdomen in children. When acute appendicitis is diagnosed, the standard treatment is excision of the appendix by surgery, but interval appendectomy (IA) may be selected for complicated appendicitis. In mild cases, it has been reported that spontaneously resolving appendicitis (SRA) can relieve symptoms without surgery or antibiotics.
At the Tokyo Metropolitan Children’s Medical Center, pediatric surgeons perform the ultrasound examination, make a definite diagnosis of acute appendicitis and classify the original severity grading, and decide on the treatment policy. If the structure of the appendix wall is maintained or if the blood flow of the wall is increased even if it is irregular, we administer an intravenous bolus infusion only with follow-up.
If the wall structure is irregular and the blood flow is reduced, or the wall structure is lost, a semi-emergency operation or IA is adopted. Appendicecal mass is preceded by antibiotic treatment, and IA is performed 3 months after the abscess has disappeared.
It was considered that the evaluation of the form of the appendix and the evaluation of blood flow by ultrasound are useful not only for diagnosis of acute appendicitis but also for determining the treatment policy.
