Accuracy of point‐of‐care ultrasound in the diagnosis of acute appendicitis in a pediatric emergency department

Abstract

AbstractPurposeTo investigate the accuracy of point‐of‐care ultrasound (PoCUS) in diagnosing acute appendicitis in children; to evaluate the concordance between PoCUS performed by a pediatric emergency physician (PedEm) and ultrasonography (US) performed by a radiologist; to draw a “learning curve.”MethodsWe prospectively enrolled children aged 0–14 years old led to the Emergency Department of Regina Margherita Children's Hospital, from January 2021 to June 2021, with suspected acute appendicitis. PoCUS was performed by a single trained PedEm, blindly to the radiologist's scan. A “self‐assessment score” and the “time of duration of PoCUS” were recorded for each patient. Final diagnosis of appendicitis was made by a pediatric surgeon.ResultsWe enrolled 62 children (2–14 years). Overall sensitivity of PoCUS was 88%, specificity 90%; PPV 90.6%, and NPV 86.6%. Global concordance between the PedEm and the radiologist was good/excellent (k 0.74). The mean duration of PoCUS significantly decreased during the study period, while the self‐assessment score increased.ConclusionThis is a preliminary study that shows the effectiveness of PoCUS in diagnosing acute appendicitis; furthermore, it shows how the PedEm's performance may improve over time. The learning curve showed how the experience of the PedEm affects the accuracy of PoCUS.