Marshall Ross1, Sasha Selby2, Naveen Poonai3, Helena Liu4, Shabnam Minoosepehr5, Graham Boag6, Robin Eccles7, Graham Thompson5. 1. *Department of Emergency Medicine,University of Calgary,Calgary,AB. 2. ¶Medical Undergraduate at University of Limerick,Limerick,Ireland. 3. ǁDepartment of Pediatrics,Western University,London, ON. 4. **Department of Medical Education,University of Alberta,Edmonton,AB. 5. †Pediatric Emergency Medicine,University of Calgary,Calgary,AB. 6. ‡Department of Radiology,University of Calgary,Calgary,AB. 7. §Department of Pediatric Surgery,University of Calgary,Calgary,AB.
Abstract
OBJECTIVES: We examined the effect of a full bladder on proportions of diagnostic ultrasound (US) studies in children with suspected appendicitis. We also examined the effect of a full bladder on proportions of fully visualized ovaries on US in children with suspected appendicitis. METHODS: We conducted a retrospective health record review of children aged 2-17 years presenting to a tertiary pediatric emergency department (ED) with suspected appendicitis who had an ultrasound performed. We compared proportions of diagnostic US studies in children with full and sub-optimally filled bladders. We also compared proportions of ovarian visualization in females with full and sub-optimally filled bladders. RESULTS: 678 children were included in our final analysis. The proportion of diagnostic US studies did not vary significantly between groups with a full (132/283, 47%, 95% confidence interval [CI] 38%-56%) or sub-optimally filled bladder (205/395, 52%, 95% CI 47%-57%)(p=0.17). Rates of ovarian visualization were higher in females with a full bladder (196/205, 96%, 95% CI 93%-99%) compared to those with a sub-optimally filled bladder (180/223, 81%, 95% CI 76%-86%) (p<0.01). CONCLUSIONS: Administrators and clinical decision makers should consider removing routine bladder filling practice from current pediatric appendicitis protocols in males and in pre-pubertal females where ovarian pathology is not suspected. Selective bladder filling prior to US should be performed in females when ovarian pathology is suspected.
OBJECTIVES: We examined the effect of a full bladder on proportions of diagnostic ultrasound (US) studies in children with suspected appendicitis. We also examined the effect of a full bladder on proportions of fully visualized ovaries on US in children with suspected appendicitis. METHODS: We conducted a retrospective health record review of children aged 2-17 years presenting to a tertiary pediatric emergency department (ED) with suspected appendicitis who had an ultrasound performed. We compared proportions of diagnostic US studies in children with full and sub-optimally filled bladders. We also compared proportions of ovarian visualization in females with full and sub-optimally filled bladders. RESULTS: 678 children were included in our final analysis. The proportion of diagnostic US studies did not vary significantly between groups with a full (132/283, 47%, 95% confidence interval [CI] 38%-56%) or sub-optimally filled bladder (205/395, 52%, 95% CI 47%-57%)(p=0.17). Rates of ovarian visualization were higher in females with a full bladder (196/205, 96%, 95% CI 93%-99%) compared to those with a sub-optimally filled bladder (180/223, 81%, 95% CI 76%-86%) (p<0.01). CONCLUSIONS: Administrators and clinical decision makers should consider removing routine bladder filling practice from current pediatric appendicitis protocols in males and in pre-pubertal females where ovarian pathology is not suspected. Selective bladder filling prior to US should be performed in females when ovarian pathology is suspected.
Authors: Gali Shapira-Zaltsberg; Nathalie A Fleming; Anna Karwowska; Maria Esther Perez Trejo; Gerald Guillot; Elka Miller Journal: Pediatr Radiol Date: 2019-07-09
Authors: S Ali Naqvi; Graham C Thompson; Ari R Joffe; Jaime Blackwood; Dori-Ann Martin; Mary Brindle; Herman W Barkema; Craig N Jenne Journal: Mediators Inflamm Date: 2019-02-21 Impact factor: 4.711