Sonographic imaging the paediatric appendix.

Abstract

Appendicitis is common source of paediatric morbidity and even mortality. While there is a range of clinical signs, the classic presentation occurs less frequently making a clinical diagnosis difficult. The evidence reports that ultrasound is an accurate and reliable way to diagnose appendicitis in children (>95%). Considering its accessibility and the absence of radiation, it is the ideal modality for diagnosis. The major disadvantage of ultrasound is its rate of indeterminate examinations. The normal appendix can be notoriously difficult to identify because of its location, bowel gas, patient movement and BMI. Borderline ultrasound features can also confuse rather than provide a negative diagnosis. Using didactic presentation and live scanning, this workshop will examine strategies for the difficult and equivocal appendix. The attendee will be challenged to identify ways to improve their visualisation rates through improved scan techniques, variable patient position and considered transducer selection and optimisation.