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One in six appendectomies on children are unnecessary new research shows


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One in six operations to remove a child’s appendix are NOT needed because doctors are failing to properly interpret ultrasound scans of the abdomen, new research shows

  • Some 10,000 children have an emergency appendectomy operations each year
  • Scientists tested the extracted organs of almost 1,900 children after surgery 
  • The tests showed that 16 per cent of those operated on did not need surgery 
  • Avoiding needless surgery could save the NHS approximately £4.4m a year 

Hundreds of children are having needless operations to remove their appendix, researchers have warned.

One in six children who had surgery actually had a healthy appendix taken out, according to their study.

An estimated 1,600 younsters are having appendicectomies unnecessarily each year in the UK, it found.

One in six children who undergo appendectomies in Britain and Ireland did not need the surgery, an examination of the extracted organs of 1,827 children has show

Such surgery is the most common emergency operation in children – with 10,000 procedures every year.

Such surgery is the most common emergency operation in children – with 10,000 procedures every year.

Such surgery is the most common emergency operation in children – with 10,000 procedures every year.

Scientists tested the extracted organs of 1,827 children after appendicectomies at 139 hospitals across Britain and Ireland.

The tests, of patients aged five to 15, showed 16 per cent never had appendicitis in the first place.

With each of the operations costing about £3,700, avoiding needless surgery could save the NHS £4.4million a year and spare hundreds of children from the knife.

Researcher Aneel Bhangu, of the University of Birmingham, said misdiagnosis ‘places an unacceptable burden on both children and their carers’. Only around a third of youngsters admitted to hospital with suspected appendicitis actually had an appendicectomy.

Of those aged between five and ten who had the procedure, 12 per cent of them were unnecessary.

Of boys aged 11 to 15, 16 per cent of the operations were needless.

This increased for girls aged 11 to 15 where 22 per cent were not needed, according to the study published in the Lancet Child and Adolescent Health journal.

So many children are being misdiagnosed because doctors are not properly interpreting the ultrasound scans used to examine them, the researchers said.

They are calling for urgent improvements to avoid more unnecessary operations. Children with suspected appendicitis should be given a routine ‘risk score’ to rule out the problem.

And those still suspected should be given an ultrasound by someone specifically trained to spot the condition. If that is inconclusive, doctors should consider a CT scan.

Study leader Dr Dmitri Nepogodiev said: ‘Obviously CT is not ideal in children due to the radiation exposure – albeit relatively low – so we would only suggest this in the small group of patients with uncertain diagnosis after ultrasound.’

He added: ‘MRI is an excellent alternative – very accurate, with no radiation – but it is unlikely that most hospitals will be able to offer MRI in the emergency setting.’ In time MRI scans may replace CT scans, but at the moment the NHS does not have enough machines.

Dr Nepogodiev added: ‘It’s important children receive the right diagnosis before a decision is made to operate. Ultrasound scans have the advantage that they do not expose children to radiation. They have been found to be an effective diagnostic tool in other countries, but we found that in the UK ultrasound is frequently inconclusive.

‘Hospitals should ensure seven-day-a-week availability of ultrasound by staff trained to assess for acute appendicitis in children.’

A study by the same team last year found the problem is even worse for adults. It said 20 per cent of adults had a completely healthy organ removed – resulting in 5,500 needless operations a year.

 

Read more at DailyMail.co.uk


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