Useful Ultrasound Findings of Pediatric Patients with Equivocal Results of Appendicitis: Analysis Based on a Structured Report Form

Aims: To evaluate ultrasound findings in order to determine potential predictors of prognosis in pediatric patients with portal venous gas (PVG) detected by ultrasound.Materials and methods: Thirty-nine children were included and divided into two groups: benign PVG (n=24) and life-threatening PVG (n=15; 6 surgical interventions and 9 deaths). Possible predictors, i.e., the location of PVG in the liver, the distribution of intestinal pneumatosis, ascites and free air were compared between the two groups.Results: A significant difference was noted between the two groups in terms of the distribution of intestinal pneumatosis (limited to the large bowel, benign vs life-threatening = 60.9% (14/23):21.4% (3/14), p=0.040), the absence of ascites (benign vs life-threatening = 79.1% (19/24):40.0% (6/15), p=0.019) and patient age (benign vs life-threatening = 52.5±65.3 months vs 19.7±44.0 months, p=0.019). No significant difference was observed in the location of PVG in the liver, the presence of free air, and sex between the two groups.Conclusions: In pediatric patients with PVG, including various ages and underlying diseases, intestinal pneumatosis limited to the large bowel and absence of ascites were predictors of a benign prognosis. However, despite the presence of these predictors, some patients with PVG required surgical intervention, therebysuggesting that the cause of PVG, such as necrotizing enterocolitis, volvulus, or pancreatitis, must be also carefully evaluated.

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Use of ultrasound findings to predict bowel ischemic changes in pediatric patients with intestinal volvulus

Journal of Ultrasound in Medicine ◽

10.1002/jum.15145 ◽

2019 ◽

Vol 39 (4) ◽

pp. 683-692 ◽

Cited By ~ 2

Author(s):

Takahiro Hosokawa ◽

Mayumi Hosokawa ◽

Yutaka Tanami ◽

Yumiko Sato ◽

Tetsuya Ishimaru ◽

...

Keyword(s):

Pediatric Patients ◽

Intestinal Volvulus ◽

Ultrasound Findings

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Accuracy of Findings of Ultrasound (USG) Examination in Pediatric Patients with suspected Appendicitis with Intraoperative Findings

International Journal of PharmTech Research ◽

10.20902/ijptr.2019.120410 ◽

2019 ◽

Vol 12 (4) ◽

pp. 70-76

Author(s):

Hari Irawan ◽

Erjan Fikri ◽

Elvita Rahmi Daulay

Keyword(s):

Pediatric Patients ◽

Lower Abdominal Pain ◽

Diagnostic Study ◽

Chi Square ◽

Suspected Appendicitis ◽

Ultrasound Study ◽

Significant Difference ◽

Ultrasound Findings ◽

Study Experience ◽

Chi Square Test

Background & Objectives: Unspecified lower abdominal pain might confuse clinicians in diagnosing pediatric appendicitis. Ultrasonography, as an initial affordable tool, has been learned its role in reducing unnecessary appendectomy. This study aimed to determine the accuracy of ultrasonography in pediatric acute appendicitis and its correlation to intraoperative findings, confirmed by histopathology results. The result would verify other study experience. Methods : The study was a diagnostic study which retrospectively review the children who underwent an ultrasound study for suspected appendicitis in pediatric surgery division of Haji Adam Malik Hospital and Universitas Sumatera Utara Hospital, Medan, North Sumatera between January 2014 until March 2019. We determined the accuracy along with sensitivity and specificity results of Ultrasonography (USG) using calculated formula. The comparation between ultrasonography results and intraoperative findings was analyzed using Chi Square test or its alternative. Results : Among the 32 patients, male and female were almost equal in 1:1 ratio, with mean age of 14.06 (±3.98) years old. Twenty-six patients were positively diagnosed as appendicitis using ultrasonography. Only two patients have no appendicitis based on intraoperative findings, confirmed by histopathology results. There is a statistically significant difference between ultrasonography findings and histopathology results (p=0,03). We obtained the accuracy of ultrasonography in predicting appendicitis was 87.5%, with 86.7% sensitivity and 100% specificity. Conclusion : Our results compare favorably with alternative studies, however indicate the potential for improvement in accuracy of image, with a future study incorporating new ways of categorizing ultrasound findings presently being undertaken.

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Audiology Service Models in a Family Physician Practice Setting

Perspectives on Audiology ◽

10.1044/poa6.1.24 ◽

2010 ◽

Vol 6 (1) ◽

pp. 24-32 ◽

Cited By ~ 2

Author(s):

Sridhar Krishnamurti

Keyword(s):

Pediatric Patients ◽

Practice Patterns ◽

Healthcare Delivery ◽

Direct Consequence ◽

Direct Access ◽

Practice Setting ◽

Pediatric Populations ◽

Family Practice Physicians ◽

Primary Focus ◽

Balance Problems

This article illustrates the potential of placing audiology services in a family physician’s practice setting to increase referrals of geriatric and pediatric patients to audiologists. The primary focus of family practice physicians is the diagnosis/intervention of critical systemic disorders (e.g., cardiovascular disease, diabetes, cancer). Hence concurrent hearing/balance disorders are likely to be overshadowed in such patients. If audiologists get referrals from these physicians and have direct access to diagnose and manage concurrent hearing/balance problems in these patients, successful audiology practice patterns will emerge, and there will be increased visibility and profitability of audiological services. As a direct consequence, audiological services will move into the mainstream of healthcare delivery, and the profession of audiology will move further towards its goals of early detection and intervention for hearing and balance problems in geriatric and pediatric populations.

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