DOES THE USE OF ULTRASONOGRAPHY IMPROVE THE OUTCOME OF CHILDREN WITH APPENDICITIS

Objective: To determine whether the use of ultrasonography (US) improv es the outcome of children with appendicitis. Methods: All cases of pa tients (<17 years old) with pathologically confirmed appendicitis trea ted in the ED between July 1992 and December 1995 were retrospectively reviewed. Results: 231 charts met criteria for analysis. 100 (43%) pa tients had US prior to surgery. Age, race, and insurance status were s imilar for children in the US and non-US groups; there were no differe nces between the groups at presentation in mean temperature, mean WBC count, or percentage of children with vomiting, diarrhea, abdominal te nderness, or guarding. Those in the non-US group were more often male (71%, p = 0.002) and more frequently had right lower quadrant pain (65 %, p = 0.003). Time from ED triage to the OR was 17.1 hours (US group) vs 10.4 hours (non-US group) (p = 0.002). The perforation rates and t he complication (abscess, wound infection, wound dehiscence) rates wer e similar for children in the two groups. Hospital charges were higher in the US group than in the non-US group ($14,123 vs $13,021, p = 0.0 07). Conclusion: The use of US did not result in early diagnosis of ap pendicitis, nor was it associated with a reduction in perforation or c omplication rates. Among children with clinical evidence of appendicit is, US was associated with a delay in surgery and an increase in hospi tal charges.