Neonatology and Perinatology

Biography

Al Hada Armed Forces Hospital is a tertiary care hospital with specialist training programmes for pediatric department. It has approximately 400 in-patient beds. The pediatric surgery unit provides tertiary care service for the region. The unit serves inpatient, outpatient, NICU and emergency. Each month 200 operations done as a day case, admit and emergency basis. He is responsible for all pediatric surgery inpatients care, NICU, PICU, OR and emergency especially trauma patients at Al Hada hospital. This region have high trauma patient due to location and high turnout of visitors to Makkah, the only link road from western region. Saudi Arabia has second in world with high morbidity and mortality related trauma. He is a dedicated and committed employee of Al Hada Hospital and he strives to achieve its vision of providing excellence in healthcare.

Abstract

Background: To determined the accuracy of ultrasound in diagnosis of acute appendicitis in children keeping histopathology as gold standard.

Methods: A prospective evaluations of all ultrasound for appendicitis from January 1, 2014, to December, 2017, was conducted at our hospital. A diagnostic protocol was adopted for each patient, US as the initial imaging modality followed by CT in patients with an equivocal clinical presentation. The imaging, operative findings, and pathology of 223 patients (females 80, males 143, age less than 14years) with diagnosed appendicitis were collected. The sensitivity, specificity, predictive value, and negative appendectomy rate were also analyzed. All those patients which had subjected to surgery were included to evaluate the true result of ultrasound in diagnosis of appendicitis.

Results: Of the 223 pediatric appendectomies performed in this time period, a total of 192 (86%) were diagnosed by ultrasound. The histopathology of 8 was normal (3.1%), CT done in 11 and three was normal. The negative appendectomy rate was 3.1%. US were the sole imaging modality in all patients.

Conclusions: In the diagnosis of acute appendicitis in children, ultrasound is useful and accurate mode, which results in a significant decrease in negative appendectomies with no increase in the number of CT scans. This has important implications in the reduction of childhood radiation exposure.