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Ned Tijdschr Geneeskd. 2003 Jun 14;147(24):1174-7.

[Diagnostic surplus value of echography in children with acute abdominal pain].

[Article in Dutch]

Author information

1
Afd. Heelkunde, Iuliana Kinderziekenhuis/Rode Kruis Ziekenhuis, Sportlaan 600, 2566 MJ Den Haag.

Abstract

OBJECTIVE:

To assess the role of echography in the diagnosis of acute abdominal symptoms in children.

DESIGN:

Prospective, descriptive.

METHOD:

During one year (1 June 1999-31 May 2000), abdominal ultrasonography was performed in all children with abdominal pain less than 2 weeks, who were referred to the emergency department of the Red Cross Hospital in The Hague (the Netherlands). An initial clinical diagnosis was made on the basis of the medical history, a physical examination and the results of laboratory tests. Subsequently, ultrasonography was performed by a radiologist who was unaware of the clinical diagnosis. A working hypothesis was reached on the basis of the clinical findings and the results of echography. The final diagnosis was made on the basis of either a histologic investigation after surgery or the condition at discharge.

RESULTS:

The study included 112 patients. The mean age was 9 years and 54% were boys. Acute appendicitis was ascertained in 48 children. The sensitivity of the clinical findings was 88% and the specificity 70%. The sensitivity of the clinical findings together with ultrasonography was 88% and the specificity 91%. The positive predictive value of the clinical findings alone was 69% and of the clinical findings together with ultrasonography 88%.

CONCLUSION:

Echography has added value in the diagnosis of acute abdominal pain in children; it increases the specificity of the physical examination. The number of negative laparotomies was decreased by the use of ultrasonography.

PMID:
12845838
[Indexed for MEDLINE]

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