## About Dataset

This repository holds the data from a cohort of pediatric patients with suspected appendicitis admitted with abdominal pain to Children’s Hospital St. Hedwig in Regensburg, Germany, between 2016 and 2021. Each patient has (potentially multiple) ultrasound (US) images, aka views, tabular data comprising laboratory, physical examination, scoring results and ultrasonographic findings extracted manually by the experts, and three target variables, namely, diagnosis, management and severity.

This dataset was acquired in a retrospective study from a cohort of pediatric patients admitted with abdominal pain to Children’s Hospital St. Hedwig in Regensburg, Germany. Multiple abdominal B-mode ultrasound images were acquired for most patients, with the number of views varying from 1 to 15. The images depict various regions of interest, such as the abdomen’s right lower quadrant, appendix, intestines, lymph nodes and reproductive organs. Alongside multiple US images for each subject, the dataset includes information encompassing laboratory tests, physical examination results, clinical scores, such as Alvarado and pediatric appendicitis scores, and expert-produced ultrasonographic findings. Lastly, the subjects were labeled w.r.t. three target variables: diagnosis (appendicitis vs. no appendicitis), management (surgical vs. conservative) and severity (complicated vs. uncomplicated or no appendicitis). The study was approved by the Ethics Committee of the University of Regensburg (no. 18-1063-101, 18-1063_1-101 and 18-1063_2-101) and was performed following applicable guidelines and regulations.

### Class Labels

Diagnosis: [appendicitis, no appendicitis],

Severity: [complicated, uncomplicated],

Management: [conservative, primary surgical, secondary surgical, simultaneous appendectomy]

**Variable Name -> Role -> Type -> Demographic -> Description**

RBC_Count -> Feature -> Continuous -> -> The number of erythrocytes in a unit volume of blood

Hemoglobin -> Feature -> Continuous -> -> Hemoglobin level; a red protein in the red blood cells that contains iron and is responsible for transporting oxygen

RDW -> Feature -> Continuous -> -> A blood test that measures the differences in the volume and size of the erythrocytes

Thrombocyte_Count -> Feature -> Integer -> -> The number of platelets in a unit volume of blood

Ketones_in_Urine -> Feature -> Categorical -> -> Presence of ketone bodies in urine, e.g. in case of anorexia

RBC_in_Urine -> Feature -> Categorical -> -> Blood in urine

WBC_in_Urine -> Feature -> Categorical -> -> Leucocytes in urine, e.g., in case of infection

CRP -> Feature -> Integer -> -> Protein produced by the liver, elevated in case of inflammation, infection, or injury

Dysuria -> Feature -> Binary -> -> Pain or other difficulty during urination

Stool -> Feature -> Categorical -> -> Characteristics of bowel movements

Peritonitis -> Feature -> Categorical -> -> Spasm of abdominal wall muscles detected on palpation, usually a result of inflammation

Psoas_Sign -> Feature -> Categorical -> -> Abdominal pain produced by extension of the hip

Ipsilateral_Rebound_Tenderness -> Feature -> Categorical -> -> A state in which pain of the ipsilateral side is felt on the release of pressure over the abdomen

US_Performed -> Feature -> Categorical -> -> If an abdominal ultrasonography was performed or not

US_Number -> Other -> Integer -> ->

Free_Fluids -> Feature -> Categorical -> -> Free fluids inside the abdomen

Appendix_Wall_Layers -> Feature -> Categorical -> -> Distribution and characteristics of appendix layers, e.g., irregular in case of an increasing inflammation

Target_Sign -> Feature -> Categorical -> -> Axial image of appendix with a fluid-filled center surrounded by echogenic mucosa and submucosa and hypoechoic muscularis

Appendicolith -> Feature -> Categorical -> -> Presence of fecalith in the appendix, e.g. acoustic shadow

Perfusion -> Feature -> Categorical -> -> Blood flow to the appendix wall

Perforation -> Feature -> Categorical -> -> Signs of appendix perforation in US

Surrounding_Tissue_Reaction -> Feature -> Categorical -> -> Inflammation signs in tissue (i.a. in omentum/fat tissue) surrounding appendix

Appendicular_Abscess -> Feature -> Categorical -> -> Appendiceal mass

Abscess_Location -> Feature -> Categorical -> -> Location of the abcess intraperitoneal

Pathological_Lymph_Nodes -> Feature -> Binary -> -> Enlarged and inflamed intra-abdominal lymph nodes

Variable Name -> Role -> Type -> Demographic -> Description -> Units

Lymph_Nodes_Location -> Feature -> Categorical -> -> The location of pathological lymph nodes in the abdomen

Bowel_Wall_Thickening -> Feature -> Binary -> -> Edema of the intestinal wall, > 2-3 mm for small bowel wall thickening

Conglomerate_of_Bowel_Loops -> Feature -> Binary -> -> Small intestine conglomerate as sign of intraperitoneal inflammation

Ileus -> Feature -> Categorical -> -> Sonographic signs of paralytic ileus (e.g., dilated intestinal loops, pendulum peristalsis or absence of peristalsis)

Coprostasis -> Feature -> Categorical -> -> Fecal impaction in the colon

Meteorism -> Feature -> Categorical -> -> Accumulation of gas in the intestine

Enteritis -> Feature -> Categorical -> -> Sonographic features of gastroenteritis, e.g. wall thickening of ileum, increased peristalsis

Gynecological_Findings -> Feature -> Categorical -> -> Gynaecological abnormalities, e.g. cysts, ovarial torsion

RBC_Count -> Feature -> Continuous -> -> The number of erythrocytes in a unit volume of blood

Hemoglobin -> Feature -> Continuous -> -> Hemoglobin level; a red protein in the red blood cells that contains iron and is responsible for transporting oxygen

RDW -> Feature -> Continuous -> -> A blood test that measures the differences in the volume and size of the erythrocytes

Thrombocyte_Count -> Feature -> Integer -> -> The number of platelets in a unit volume of blood

Ketones_in_Urine -> Feature -> Categorical -> -> Presence of ketone bodies in urine, e.g. in case of anorexia

RBC_in_Urine -> Feature -> Categorical -> -> Blood in urine

WBC_in_Urine -> Feature -> Categorical -> -> Leucocytes in urine, e.g., in case of infection

CRP -> Feature -> Integer -> -> Protein produced by the liver, elevated in case of inflammation, infection, or injury

Dysuria -> Feature -> Binary -> -> Pain or other difficulty during urination

Stool -> Feature -> Categorical -> -> Characteristics of bowel movements

Peritonitis -> Feature -> Categorical -> -> Spasm of abdominal wall muscles detected on palpation, usually a result of inflammation

Psoas_Sign -> Feature -> Categorical -> -> Abdominal pain produced by extension of the hip

Ipsilateral_Rebound_Tenderness -> Feature -> Categorical -> -> A state in which pain of the ipsilateral side is felt on the release of pressure over the abdomen

US_Performed -> Feature -> Categorical -> -> If an abdominal ultrasonography was performed or not

US_Number -> Other -> Integer -> ->

Free_Fluids -> Feature -> Categorical -> -> Free fluids inside the abdomen

Appendix_Wall_Layers -> Feature -> Categorical -> -> Distribution and characteristics of appendix layers, e.g., irregular in case of an increasing inflammation

Target_Sign -> Feature -> Categorical -> -> Axial image of appendix with a fluid-filled center surrounded by echogenic mucosa and submucosa and hypoechoic muscularis

Appendicolith -> Feature -> Categorical -> -> Presence of fecalith in the appendix, e.g. acoustic shadow

Perfusion -> Feature -> Categorical -> -> Blood flow to the appendix wall

Perforation -> Feature -> Categorical -> -> Signs of appendix perforation in US

Surrounding_Tissue_Reaction -> Feature -> Categorical -> -> Inflammation signs in tissue (i.a. in omentum/fat tissue) surrounding appendix

Appendicular_Abscess -> Feature -> Categorical -> -> Appendiceal mass

Abscess_Location -> Feature -> Categorical -> -> Location of the abcess intraperitoneal

Pathological_Lymph_Nodes -> Feature -> Binary -> -> Enlarged and inflamed intra-abdominal lymph nodes