Abdus Sarni Qazi.
Sonographic Appearance of Normal Appendix in Children.
Proceeding Shaikh Zayed Postgrad Med Comp Jan ;22(1):57-62.

Objective: To prospectively evaluate sonographic features of a normal appendix and to determine frequency with which normal appendix can be visualized in an Emergency Department in the paediatric age group using commercially available 3.75 MHz probe with a view to confidently differentiate normal from inflamed appendix, a decision of great importance whereby an unnecessary appendectomy can be avoided in a good number of cases. Material and Methods: A total of 300 consecutive children (140 males and 160 females, median age 10 .2 years, range 8-14 years) without clinical signs of acute appendicitis were examined in the Emergency Department of Lahore General Hospital, Lahore by transabdominal sonography using commercially available 3.75 MHz curved array probe. The detection rate, outer appendiceal diameter, appendiceal intraluminal contents and peri-appendiceal tissues were evaluated. Results: Normal appendix could be visualized in 58 out of 300 (19.3%) patients. In the remaining 242 it could not be visualized in the set time of 5 minutes. Mean outer appendiceal diameter was noted to be 4.27 mm (range 3.0 mm to 6.3 mm). In 53 of 58 (91%) patients with depicted appendices, the appendix was found to be in classical location whereas it was retrocecal in location in the remaining 5 (9%) patients. In . a\\ the cases the appendix was noted to be easily compressible and in 43 out of S& (74%) norma\ appendices, the lumen was noted to be filled with fluid. It was noted to be empty in 18 out of 58 (32%) patients whereas air could be detected in 2 (4%) patients. No change was noted in the sonographic appearance of periappendiceal soft tissues. Mildly enlarged ·mesenteric lymph nodes in the right iliac fossa were seen in just 3 (5%) patients. None of the evaluated normal children showed localized fluid collection. Conclusion: Normal appendix was visualized in 19.3% of the normal children using commercially available 3.75 MHz probe which is usually a standard probe supplied with all commonly available u·ltrasound machines. The detection rate is towards the lower side of the results claimed in recent studies using high frequency linear probes and utilizing Tissue Harmonic Imaging (THI) technique.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com