[Updated on Apr. 18] Integration of CiNii Articles into CiNii Research

Clinical Significance of Appendicolith Detected Sonographically in the Management of Acute Appendicitis in Children

  • Yoshimoto Kazuhiko
    Department of Surgery, Tokyo Metropolitan Children's Medical Center:Department of Pediatric Surgery, Postgraduate School of Medical Science, Kumamoto University
  • Kamagata Shoichiro
    Department of Surgery, Tokyo Metropolitan Children's Medical Center
  • Inomata Yukihiro
    Department of Pediatric Surgery, Postgraduate School of Medical Science, Kumamoto University
  • Hirobe Seiichi
    Department of Surgery, Tokyo Metropolitan Children's Medical Center
  • Toma Miki
    Department of Surgery, Tokyo Metropolitan Children's Medical Center
  • Komori Koji
    Department of Surgery, Tokyo Metropolitan Children's Medical Center
  • Masuya Ryuta
    Department of Surgery, Tokyo Metropolitan Children's Medical Center

Bibliographic Information

Other Title
  • 急性虫垂炎の術前超音波検査での糞石像の臨床的意義について
  • キュウセイ チュウスイエン ノ ジュツゼン チョウオンパ ケンサ デ ノ フンセキゾウ ノ リンショウテキ イギ ニ ツイテ

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Abstract

Purpose: In this study, we evaluated the significance of appendicolith detected sonographically (ADS) as indication for appendectomy in children. Methods: We retrospectively studied 219 pre-selected children (83 girls and 136 boys; age: 2 to 15 years) who were sonographically diagnosed with acute appendicitis. We investigated whether the sonographic findings were correlated with the pathological reports after surgical appendectomy or with clinical findings after discharge from the hospital. Results: We observed that 74 (83%) of 89 patients with ADS and 54 (42%) of 130 patients without ADS had undergone appendectomies (p<0.0001); appendicitis was confirmed histologically in all the children, and no normal appendices were removed in this series. Presence of ADS was associated with a 33% of recurrent appendicitis compared with a 24% in those without ADS. All the children with and without ADS initially received conservative therapy without surgery. The recurrent rate was 33% in children with ADS and 24% in the children without ADS. Therefore, no significant difference was observed in the recurrence rate between children with and without ADS. Conclusion: ADS may be a marker of increased risk of appendectomy, but it is not an indication for appendectomy and does not provide enough proof of recurrence of appendicitis and resorting to surgery. Thus, we believe that an indication for appendectomy is dependent on ultrasonographically detectable changes in the appendix wall itself.

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