Diagnostic Accuracy of Pediatric Abdominal Ultrasound: Do You Need a Full Bladder?

Ultrasound has replaced computed tomography (CT) as the initial imaging study for most children with suspected appendicitis. Some institutions require bladder filling to facilitate ultrasound examinations, but this can be uncomfortable and delay care. These authors evaluated the diagnostic accuracy of transabdominal ultrasound with and without filled bladders in a retrospective cohort of 678 children with suspected appendicitis at a single center.

Ultrasound images were reviewed to determine the percent of expected bladder capacity; bladders filled to <75% capacity were considered suboptimally filled. Ultrasound reports were considered to be “diagnostic” if they demonstrated a fully visualized normal appendix, appendicitis, or an alternative…