Sonography of suspected acute appendicitis in children: Evaluation of the progress in performance of senior residents

Purpose: The objective of this study was to evaluate the progress in performance of senior residents in diagnosing acute appendicitis.

Material and methods: Results were collected and compared of ultrasound examinations performed for suspected acute appendicitis by three senior residents and two faculty members over a six-month period in a university hospital setting. A grid with the sonographic findings was completed separately by the residents and the faculty members immediately after each examination. The duration of each examination was reported. The final ultrasound diagnosis was compared to the surgical and pathological results and to the clinical follow-up.

Results: The residents and faculty members performed 171 consecutive ultrasound examinations including 49 children with acute appendicitis and 122 with normal appendices. The accuracy of the diagnosis by the residents was 96%, and was similar to that of the faculty members (kappa=0.90) over the six months. The duration of the resident ultrasound examinations was significantly shorter during the second three-month period (p=0.01). No significant differences in diagnostic accuracy were demonstrated by the residents between the first and second three-month periods (p=0.06).

Conclusions: The residents performed well when using sonography to diagnose acute appendicitis in children, and were faster during the second three-month period.

Level of evidence: I.