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Cohort study
Abdominal pain duration impacts the accuracy of ultrasound for diagnosing paediatric appendicitis
  1. Andrea S Doria
  1. Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
  1. Correspondence to: Andrea S Doria
    Department of Diagnostic Imaging, The Hospital for Sick Children, Diagnostic Imaging, 555 University Avenue, Toronto, Ontario, Canada M5G1X8; andrea.doria{at}

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Commentary on: Bachur RG, Dayan PS, Bajaj L, et al. Paediatric Emergency Medicine Collaborative Research Committee of the American Academy of Paediatrics. The effect of abdominal pain duration on the accuracy of diagnostic imaging for paediatric appendicitis. Ann Emerg Med 2012;60:582–90.


Imaging has a paramount role in the management of paediatric appendicitis because of the fact that false-negative results from clinical examination lead only to a delay in diagnosis which may result in perforation of the appendix, thus increasing the morbidity of the disease. However, false-positive results lead to an increased rate of negative laparotomies. Ultrasonography (US) is an imaging modality that does not expose the patient to radiation and is relatively inexpensive, but is operator dependent. As a result, its diagnostic accuracy is highly related to the operator's level of experience. Furthermore, in many instances the appendix is not completely visualised, resulting …

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  • Competing interests None.