Appendicitis in childhood: usefulness of ultrasound in diagnosis

The decision to perform ultrasonography (US) in children with suspected appendicitis must ultimately be made by the surgeon or pediatrician. Children with a high clinical likelihood of appendicitis are unlikely to benefit from sonographic evaluation. US is likely to be most beneficial when the clinical findings are indeterminate, both to establish the diagnosis of appendicitis and to aid in the diagnosis of other causes of acute abdominal pain. When US of the right lower quadrant is negative for appendicitis, pelvic US should be performed in female patients to exclude acute gynecologic disorders. A sonographic survey of the upper abdomen is also mandatory to diagnose other disorders causing acute abdominal pain.