Increased incidence of negative appendectomy in childhood obesity

Kutasy, Balázs; Hunziker, Manuela; Laxamanadass, Ganapathy; Puri, Prem

doi:10.1007/s00383-010-2646-x

Cited by 26 publications

(19 citation statements)

References 16 publications

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“…33 Contrary to our results, a recent large study found obesity associated with a high negative appendectomy rate. 34 The explanation for this discrepancy may in part lie in the relatively high imaging rate of our study population, including some of those with a high clinical suspicion of appendicitis. Many children with equivocal US were reimaged, as were those with discrepancies between US results and clinical findings.…”

Section: Discussionmentioning

confidence: 86%

Clinical Outcomes in Obese and Normal-weight Children Undergoing Ultrasound for Suspected Appendicitis

Sulowski¹,

Doria²,

Langer³

et al. 2011

Academic Emergency Medicine

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Background: Obesity constitutes an independent predictor for a nondiagnostic screening ultrasound (US) in suspected appendicitis. Furthermore, the imaging route consisting of the screening US with a second US if necessary has a significantly lower diagnostic accuracy in the obese children (83%) than their lean counterparts (93%). However, the effect of this association on clinical outcomes in the obese population is unknown.

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Section: Discussionmentioning

confidence: 86%

Clinical Outcomes in Obese and Normal-weight Children Undergoing Ultrasound for Suspected Appendicitis

Sulowski¹,

Doria²,

Langer³

et al. 2011

Academic Emergency Medicine

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“…19 Furthermore, the low sensitivity and specificity of US in these children could lead to an increased rate of negative appendectomy. 20 Despite these limitations, the pediatric literature recommends US before CT scan in the workup of the patient with appendicitis. 18,21,22 Our data revealed that 99.3% of the patients studied received either an US or a CT scan to confirm appendicitis; only 2 children underwent appendectomy without preoperative imaging.…”

Section: Discussionmentioning

confidence: 99%

Increased Incidence of Perforated Appendicitis in Children With Obesity

Blanco

Sandler

Nadler

2012

Clin Pediatr (Phila)

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Based on their clinical impression, the authors hypothesized that children with obesity may more commonly present with perforated appendicitis. Therefore, the authors reviewed their experience from 2008 to 2010 to determine whether obesity affected the clinical presentation of appendicitis. Variables studied were height, weight, use of diagnostic imaging, and clinical findings of appendicitis at presentation. Outcomes assessed were length of stay and complication rate. The study identified 319 patients with appendicitis. Children with obesity were more likely (P = .026) to present with perforation (28/62, 45%) than nonobese patients (78/257, 30%). Neither length of stay nor complication rate was affected by the presence of obesity. The data suggest that children with obesity are more likely to present with perforated appendicitis. This finding suggests that the diagnosis of appendicitis may be more difficult in obese patients or their presentation may be delayed. Practitioners should have heightened awareness in children with obesity and symptoms of abdominal pain.

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“…This modality became less commonly used as CT became more widespread in the setting of acute appendicitis [41]. While US specificity rivals that of CT [15,17,44], US accuracy is operator-dependent [19], and the results may be less reliable in pediatric patients with higher body mass index [45], although the latter is debated [46]. In fact, US may have an increased diagnostic accuracy in children with higher body mass index as fat stranding would theoretically be more visible in such patients [47]; this theory has not been systematically evaluated, however.…”

Section: Discussionmentioning

confidence: 99%

Protocol for suspected pediatric appendicitis limits computed tomography utilization

Wagenaar

Tashiro

Wang

et al. 2015

Journal of Surgical Research

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Increased incidence of negative appendectomy in childhood obesity

Abstract: Suspected appendicitis in childhood obesity is associated with increased incidence of normal appendectomy. Active observation in hospital in very obese children may reduce the rate of normal appendectomy without increasing the incidence of complicated appendicitis.

Cited by 26 publications

References 16 publications

Clinical Outcomes in Obese and Normal-weight Children Undergoing Ultrasound for Suspected Appendicitis

Clinical Outcomes in Obese and Normal-weight Children Undergoing Ultrasound for Suspected Appendicitis

Increased Incidence of Perforated Appendicitis in Children With Obesity

Protocol for suspected pediatric appendicitis limits computed tomography utilization

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