Features affecting the sensitivity of ultrasonic examination in the diagnosis of abdominal pain in children. A review of the literature
Abstract
This literature review systematizes current data on the capabilities and limitations of ultrasound (US) in diagnosing abdominal pain in children, with a focus on acute appendicitis. US is the preferred method in pediatric practice due to its safety, accessibility, and diagnostic value. For non-perforated appendicitis, the sensitivity of US reaches 88–94%, and specificity is 90–96%, comparable to computed tomography but without radiation exposure. US effectively detects intestinal intussusception (accuracy up to 98%), hepatobiliary pathologies, mesenteric lymphadenitis, and certain gynecological conditions. However, diagnosing perforated appendicitis remains challenging, with US sensitivity dropping to 55%. Key limitations include operator dependence (a 15–20% reduction in accuracy without pediatric radiology specialists), obesity, bowel gas, and adhesive processes. The method’s efficacy varies by clinical context: routine US does not always shorten diagnostic time, but selective use accelerates diagnosis by 30–40%.
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