Primary Objective:

 The primary objective of this study is to evaluate the ED experience of AUBMC during the past five years (2009-2014) with pediatric cases with suspected appendicitis by studying clinical features of the patient(signs, symptoms and lab studies), focusing on imaging modalities for diagnosis accuracy, and assessing management options.

Secondary Objective:

1-      Formulate a protocol to assess pediatric patients with suspected appendicitis depending on certain variables according to PAS and Alvarado score

2-      Find the best accurate method of imaging to diagnose appendicitis in children at our ED according to specific variables or characteristics (age, sex, weight, signs, symptoms, and lab studies of the PAS and Alvarado Score)

3-      Compare ED Length of stay by imaging modality

4-      Assess different imaging outcomes and diagnoses for pediatric patients with suspected appendicitis 

Study Endpoints:

Primary Outcome:

Describe the clinical features of pediatric patients with suspected appendicitis, imaging modalities (CT or ultrasound) for diagnosis accuracy, and ED management of those patients.

Imaging accuracy will be assessed by comparing CT and ultrasound imaging to the final diagnosis (pathology result) as the reference standard.

Sensitivity, Specificity, PPV, and NPV will be calculated for the imaging modalities

Secondary Outcome:

1-      Compare ED Length of stay by imaging modality

2-      Assess different imaging outcomes and diagnoses for pediatric patients with suspected appendicitis 

The study population will consist of pediatric patients presented to ED with suspected appendicitis (assessment done by the ED physician) within the past 5 years (2009-2014). Pediatric patients presented to ED with suspected appendicitis will be queried for the period between January 1, 2009 and August 30, 2014. Imaging requested on pediatric patients through ER to rule out appendicitis and pediatric patients admitted for appendectomy through ER will help in filtering the cases required for the study (in addition to the AUBMC medical records

They will have Suspected Appendicitis or Appendicitis as their final diagnosis.

Retrospective database and chart review.