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Objective: Acute appendicitis constitutes 11.4% of admissions to the pediatric emergency department and it warrants surgical intervention. In contrast, lymphoid hyperplasia of the appendix is a clinical condition secondary to inflammation and may regress without surgery. However, these two conditions can overlap. The differentiation of the two clinical diagnoses is important because complications may occur with unnecessary surgical intervention. In this study, we aimed to differentiate between the two conditions using sonographic criteria in pediatric patients.
Material and Method: Ultrasound reports and images of patients between the aged 0–18 years who underwent surgical intervention with the diagnosis of acute appendicitis were reevaluated retrospectively via the hospital medical archive. Patients were divided into two groups: those with lymphoid hyperplasia and those with acute appendicitis. We evaluated lamina propria thickness, periapendicular echogenicity, mural hyperemia, lymph node enlargement, and pericecal collection.
Results: A total of 222 patients ranging in age from 9 months to 17 years were included in this study. The lymphoid hyperplasia group included 100 patients, and the acute appendicitis group included 122 patients. The most important criterion for predicting acute appendicitis was lamina propria thickness at a cutoff value of 0.9 mm with a sensitivity of 88% and specificity of 85%. Periappendicular echogenicity, collection, and mural hyperemia were among the findings that indicated acute appendicitis, whereas pericecal lymph node presence was not significant (p<0.01).
Conclusion: In pediatric patients, the most important criterion for the differential diagnosis of lymphoid hyperplasia of the appendix
from acute appendicitis is lamina propria thickness.
Cite this article as: Aydın S, Fatihoğlu E. Detection of Useful Sonographic Findings to Discriminate Acute Appendicitis and Lymphoid Hyperplasia of Appendix in Pediatric Patients. Arch Basic Clin Res 2020; 2(2): 33-6.