Diagnostic errors of right lower quadrant pain in children: beyond appendicitis

Chang, Patricia; Schooler, Gary R.; Lee, Edward Y.

doi:10.1007/s00261-015-0482-0

Cited by 13 publications

(5 citation statements)

References 29 publications

(29 reference statements)

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“…Many of these conditions in the pediatric population are initially evaluated with ultrasound studies. 9 A few case reports similarly discuss the initial evaluation of RLQ pain for appendicitis that revealed alternate pathology. One such case report discussed the use of ultrasound to diagnose a torn rectus abdominus muscle.…”

Section: Discussionmentioning

confidence: 99%

Ureteral Stone Mimics Appendicitis: A Point-of-care Ultrasound Case Report

Shavor

Pagenhardt

Sun

et al. 2020

Clinical Practice and Cases in Emergency Medicine

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Introduction: Abdominal pain is a common complaint in the emergency department. Point-of-care ultrasound (POCUS) is a rapid modality to evaluate for the etiology. Case Report: A teenage male presented with symptoms concerning for appendicitis. POCUS revealed a non-peristalsing, non-compressible, tubular structure containing an echogenic stone. This was determined to be a ureteral stone within a dilated ureter, not appendicitis. Conclusion: We propose a syndromic sonographic approach to right lower quadrant pain (RLQ) that includes the gallbladder, right kidney, bladder, and right adnexa, in addition to RLQ landmarks. This case emphasizes the value of such an approach to avoid diagnostic error.

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Section: Discussionmentioning

confidence: 99%

Ureteral Stone Mimics Appendicitis: A Point-of-care Ultrasound Case Report

Shavor

Pagenhardt

Sun

et al. 2020

Clinical Practice and Cases in Emergency Medicine

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show abstract

“…3,4 MRI, on the other hand, is used in selected pediatric cases because it is not easily accessible despite the absence of radiation exposure, may require sedation, and the duration of application is long. 3,5,6 Ultrasonography (US) consisting of both gray scale and Doppler mode is the main diagnostic imaging modality for the diagnosis of OT. 7 Although gray scale US define ovarian morphology, does not give specific findings for OT.…”

Section: Introductionmentioning

confidence: 99%

“…CT is not primarily preferred in the diagnosis of OT because it requires radiation exposure and children are more radiosensitive than adults 3,4 . MRI, on the other hand, is used in selected pediatric cases because it is not easily accessible despite the absence of radiation exposure, may require sedation, and the duration of application is long 3,5,6 . Ultrasonography (US) consisting of both gray scale and Doppler mode is the main diagnostic imaging modality for the diagnosis of OT 7 .…”

Section: Introductionmentioning

confidence: 99%

Diagnostic failures in ovarian torsion during childhood: The effect of ovarian cyst size on the diagnostic accuracy of Doppler ultrasonography

Ulusoy

Karakuş

Ateş

et al. 2022

J of Clinical Ultrasound

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To determine the diagnostic accuracy of Doppler ultrasonography (US) in pediatric ovarian torsion (OT) and the effect of ovarian cyst size on the effectiveness of Doppler US in pediatric OT. Methods: We retrospectively reviewed of the data of 84 patients (4-17 years) operated with the preliminary diagnosis of OT from January 2007 to December 2019. Patients' demographic characteristics, clinical signs and symptoms, laboratory and radiologic findings, operative management, histopathological results, and postoperative complications were recorded. Results: OT was surgically confirmed in 53 (63%) patients. In 30 patients without ovarian cyst, Doppler US suggested OT in 16 out of 22 patients with surgically confirmed OT. In 12 patients with ovarian cysts <5 cm, Doppler US suggested OT in 7 out of 8 patients with surgically confirmed OT. In 42 patients with ovarian cysts

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“…Therefore, MRI is more frequently utilized for the diagnosis of hepatobiliary and gynecological diseases rather than the evaluation of gastrointestinal diseases (11,12). However, recent technical development including the reduction of motion artifacts has enabled indication of MRI in diagnosing acute appendicitis (13)(14)(15)(16)(17)(18)(19), especially in pediatric and pregnant patients (20)(21)(22)(23)(24).…”

Section: Introductionmentioning

confidence: 99%

Optimization of pulse sequences in ultrafast magnetic resonance imaging for the diagnosis of acute abdominal pain caused by gastrointestinal disease

Inoue

Furukawa

Nitta

et al. 2020

Acta Radiologica Open

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Background Magnetic resonance imaging (MRI) is widely used to diagnose acute abdominal pain; however, it remains unclear which pulse sequence has priority in acute abdominal pain. Purpose To investigate the diagnostic accuracy of MRI and to assess the conspicuity of each pulse sequence for the diagnosis of acute abdominal pain due to gastrointestinal diseases Material and Methods We retrospectively enrolled 60 patients with acute abdominal pain who underwent MRI for axial and coronal T2-weighted (T2W) imaging, fat-suppressed (FS)-T2W imaging, and true-fast imaging with steady-state precession (True-FISP) and axial T1-weighted (T1W) imaging and investigated the diagnosis with endoscopy, surgery, histopathology, computed tomography, and clinical follow-up as standard references. Two radiologists determined the diagnosis with MRI and rated scores of the respective sequences in assessing intraluminal, intramural, and extramural abnormality using a 5-point scale after one month. Diagnostic accuracy was calculated and scores were compared by Wilcoxon-signed rank test with Bonferroni correction. Results Diagnostic accuracy was 90.0% and 93.3% for readers 1 and 2, respectively. Regarding intraluminal abnormality, T2W, FS-T2W, and True-FISP imaging were superior to T1W imaging in both readers. FS-T2W imaging was superior to True-FISP in reader 2 ( P < 0.0083). For intramural findings, there was no significant difference in reader 1, whereas T2W, FS-T2W, and True-FISP imaging were superior to T1W imaging in reader 2 ( P < 0.0083). For extramural findings, FS-T2W imaging was superior to T2W, T1W, and True-FISP imaging in both readers ( P < 0.0083). Conclusion T2W and FS-T2W imaging are pivotal pulse sequences and should be obtained before T1W and True-FISP imaging.

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Diagnostic errors of right lower quadrant pain in children: beyond appendicitis

Cited by 13 publications

References 29 publications

Ureteral Stone Mimics Appendicitis: A Point-of-care Ultrasound Case Report

Ureteral Stone Mimics Appendicitis: A Point-of-care Ultrasound Case Report

Diagnostic failures in ovarian torsion during childhood: The effect of ovarian cyst size on the diagnostic accuracy of Doppler ultrasonography

Optimization of pulse sequences in ultrafast magnetic resonance imaging for the diagnosis of acute abdominal pain caused by gastrointestinal disease

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