P197 Retrospective cohort study on paediatric appendicectomies and the use of diagnostic ultrasound at university hospital limerick. (June 2019)

• Record Type: Journal Article
• Authors: Paluck, Felicia; O'Connell, Robert M; Tormey, Shona
• Is Part Of: Archives of disease in childhood. Volume 104:(2019)Supplement 3
• Page Start: A237
• Page End: A237
• Publication Date: 2019-06
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2019-epa.552
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Background: Acute abdominal pain in children remains a common presentation to A&E departments across Ireland. Appendicectomy remains a common procedure done in children. In this study we aimed to analyse the number of paediatric appendicectomies from August 2016-August 2018 at the University Hospital Limerick (UHL), and the use of imaging in the diagnosis of acute appendicitis. Methods: Using the Hospital Inpatient Enquiry (HIPE) administrative database, all paediatric patients (≤16 years) who underwent an appendicectomy at UHL from August 2016- August 2018 were identified retrospectively. Data were collected on each patient as follows: imaging and results, surgery (open or laproscopic appendicectomy) and histology of appendix. Negative appendicectomy rates and ultrasound diagnostic yields were calculated. Results: From August 2016- August 2018, 474 paediatric patients had an appendicectomy at UHL. Of these, 251 were male (52.8%). 373 patients had histological evidence of appendicitis (78.7%), 55 (11.6%) had evidence of lymphoid hyperplasia, enterobius and/or fecolith with no inflammation and 46 (9.7%) had a normal appendix. There were 303 (63.9%) laparoscopic appendicectomies and 171 (36.1%) open appendicectomies. Only 156 (32.8%) patients had ultrasounds. 104 (66.7%) patient ultrasounds were reported inconclusive for appendicitis. 64 (61.54%) of the patients with an inconclusive ultrasound yield had appendicitis. Conclusions: Ultrasound remains a poor imaging modality in diagnosing appendicitis, which may contribute to the high negative appendicectomy rates.