{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T03:08:10Z","timestamp":1773284890851,"version":"3.50.1"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"1093","license":[{"start":{"date-parts":[[2018,9,12]],"date-time":"2018-09-12T00:00:00Z","timestamp":1536710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,1,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>To compare pre-operative ultrasound to histopathological results and retrospectively assess the diagnostic accuracy of ultrasound in paediatric appendicitis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods:<\/jats:title>\n                  <jats:p>5 year review of all appendectomies performed in patients &amp;lt;16 years old in a tertiary referral university hospital. 983 patients had an appendicectomy over the time period while 189 patients had a preoperative ultrasound. We retrospectively reviewed all of the preoperative imaging in conjunction with the reports for the 189 patients; our aim was to determine the sensitivity of preoperative ultrasound for the diagnosis of acute appendicitis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>Of the 189 patients who had an ultrasound, 102 had histology positive for appendicitis and 87 had normal histology. Sensitivity overall was 72.55% [95% confidence interval (CI) 62.82 to 80.92] and specificity was 77.01% (95% CI 66.75 to 85.36). A suggested ultrasound diagnosis of appendicitis made positive pathology three times more likely and a normal ultrasound made positive pathology three times less likely [positive-predictive value 3.16 (95% CI 2.11 to 4.72) negative predictive value 0.36 (95% CI 0.25 to 0.50)]. 77% (67\/87) of the patients whose pathology was ultimately normal had an ultrasound which was either normal or suggested an alternative diagnosis. However, in the 33 (17%) of patients with a non-visualised appendix, no secondary signs of inflammation or alternative diagnosis 16 (48%) had pathologically confirmed appendicitis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion:<\/jats:title>\n                  <jats:p>Ultrasound has the potential to improve diagnostic accuracy in clinically ambiguous appendicitis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Advances in knowledge:<\/jats:title>\n                  <jats:p>This paper furthers the evidence on the efficacy of ultrasound as a diagnostic tool in acute appendicitis in children, especially when the diagnosis is clinically equivocal. It also sheds further light on the \u201cnon-visualized appendix\u201d with almost half of these patients having pathologically confirmed appendicitis; meaning advanced imaging with CT or MR may be indicated in this cohort.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1259\/bjr.20180585","type":"journal-article","created":{"date-parts":[[2018,8,13]],"date-time":"2018-08-13T17:52:10Z","timestamp":1534182730000},"source":"Crossref","is-referenced-by-count":6,"title":["Improving diagnostic accuracy in clinically ambiguous paediatric appendicitis: a retrospective review of ultrasound and pathology findings with focus on the non-visualised appendix"],"prefix":"10.1093","volume":"92","author":[{"given":"BS","family":"Kelly","sequence":"first","affiliation":[{"name":"Department of Radiology, Galway University Hospital , Galway , Ireland"},{"name":"Departmentof Radiology, St Vincents University Hospital, Elm park , Dublin , Ireland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SM","family":"Bollard","sequence":"additional","affiliation":[{"name":"Department of Surgery, Galway University Hospital , Galway , Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Weir","sequence":"additional","affiliation":[{"name":"Department of Radiology, Galway University Hospital , Galway , Ireland"},{"name":"Departmentof Radiology, St Vincents University Hospital, Elm park , Dublin , Ireland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"Departmentof Radiology, St Vincents University Hospital, Elm park , Dublin , Ireland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Mullen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Galway University Hospital , Galway , Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Kerin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Galway University Hospital , Galway , Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Department of Radiology, Galway University Hospital , Galway , Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2018,9,12]]},"reference":[{"key":"2024050214565426300_b1","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1097\/SLA.0000000000001099","article-title":"Pediatric emergency appendectomy and 30-day postoperative outcomes in district general hospitals and specialist pediatric surgical Centers in England, April 2001 to March 2012: Retrospective Cohort Study","volume":"263","author":"Giuliani","year":"2016","journal-title":"Ann 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