LAUSR

Prompt and accurate diagnosis of appendicitis in children is crucial to avert the risks of delayed treatment and reduce unnecessary appendectomies resulting from false-positive diagnoses. This audit aimed to evaluate the diagnostic sensitivity of ultrasound imaging in paediatric patients presenting with suspected acute appendicitis at a District General Hospital, seeking to meet or exceed the Royal College of Radiologists' (RCR) recommended target sensitivity of over 85% (1). In this retrospective study, we analysed the medical records of 102 children aged 2-16 who underwent appendectomies (open, laparoscopic, or diagnostic) over a two-year period. Ultrasound scans and corresponding medical records were reviewed to assess the concordance between pre-operative ultrasound findings and post-operative histopathology results. Among the 102 patients evaluated, histopathology confirmed appendicitis in 77 cases. Ultrasound correctly identified 52 of these cases, resulting in a diagnostic sensitivity of 67.5%, below the RCR's advised benchmark of 85%. For the 25 patients without histopathological evidence of appendicitis, ultrasound accurately diagnosed 17. The diagnostic sensitivity of ultrasound for suspected appendicitis in our paediatric cohort was below the RCR guideline, highlighting a need for improvement. To enhance diagnostic accuracy, we recommend additional training for sonographers in paediatric appendicitis imaging and consideration of second-opinion protocols for equivocal cases. Further investigation into a dedicated paediatric ultrasound service may also be another way of to improve quality of scans.