AB037. SOH26AB_0449. Delayed imaging, delayed decisions: the effect of weekend ultrasound constraints in paediatric acute abdomen
Paediatrics Session

AB037. SOH26AB_0449. Delayed imaging, delayed decisions: the effect of weekend ultrasound constraints in paediatric acute abdomen

Eibhlin Burns Beattie1, Wame Majeremane1, Austin Kerin1, Mohamed Ismaiel1, Tara Connelly1,2

1Department of Surgery, University Hospital Limerick, Limerick, Ireland; 2Health Research Institute (HRI), University of Limerick, Limerick, Ireland

Background: Admission outside weekday, daytime hours reduces access to paediatric ultrasound (USS), potentially delaying timely diagnosis in children with abdominal pain. Limited weekend USS often prolongs the pathway to operative decision-making and contributes to greater variability in care. These constraints have been linked to higher negative appendicectomy rates (NARs) and longer hospital stays, highlighting the importance of understanding how imaging availability shapes paediatric emergency workflows. The aim of this study was to determine the effects of possible delays in performing abdominal USS in a paediatric population.

Methods: A retrospective review of 145 paediatric general surgical admissions (January–July 2025) was conducted. Outcomes included USS utilisation, time to scan, surgery rate, time to surgery, length of stay (LOS), and NAR. Patients were stratified into four admission cohorts based on weekday/weekend and in-hours/out-of-hours presentation.

Results: Weekend admissions were significantly less likely to undergo USS compared with weekday presentations (35.5% vs. 63.9%, P=0.007). Among those who received imaging, weekend patients waited substantially longer for USS (median 34.8 vs. 9.85 h, P<0.001). A significantly lower NAR was observed for operations performed on Mondays compared with Tuesday–Friday (5.9% vs. 33.3%, P=0.03), consistent with improved diagnostic accuracy following restoration of weekday USS services. Children who underwent surgery had a significantly longer LOS than those managed non-operatively (median, 2 vs. 1 days, P<0.05). No significant differences in overall surgery rates were observed between the four admission cohorts.

Conclusions: Weekend limitations in paediatric USS access significantly reduce scan utilisation and prolong time to imaging, shifting diagnostic clarification and operative planning into early weekdays. Enhancing weekend USS capacity may reduce delays, improve diagnostic accuracy, and allow more balanced distribution of operative workload across the week.

Keywords: Appendicectomy; appendicitis; length of stay (LOS); paediatrics; ultrasonography

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab037
Cite this abstract as: Beattie EB, Majeremane W, Kerin A, Ismaiel M, Connelly T. AB037. SOH26AB_0449. Delayed imaging, delayed decisions: the effect of weekend ultrasound constraints in paediatric acute abdomen. Mesentery Peritoneum 2026;10:AB037.

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