[Ultrasonics in acute appendicitis. A prospective study].
In a prospective study 404 unselected patients suspected of having acute appendicitis were examined by ultrasound, the results being compared with the initial clinical findings. Acute appendicitis was established in 27.2%, confirmed by histology. The overall accuracy of ultrasonography in relation to the diagnosis of appendicitis was 95.5%, 95.1% when positive, 95.7% when negative. An acutely inflamed appendix could not be demonstrated by ultrasound in 13 patients (sensitivity 88.2%), while in five there was a false-positive ultrasound result (specificity 98.3%). Complicated appendicitis with perforation occurred in 22 patients (20%): ultrasound sensitivity in this situation was 91%. Especially when the clinical picture was unclear (34.5% of all cases of appendicitis) a definitive diagnosis of acute appendicitis was made both earlier and more certainly by ultrasonography. Further-more, in many instances ultrasound was able to demonstrate other serious disease in the differential diagnosis from acute appendicitis. Negative laparotomy rate was lowered from 21.9% to 11.4% by taking into account ultrasonographic findings. Thus ultrasonography proved to be an important method as an imaging technique and in the differential diagnosis of acute appendicitis.
Schwerk
W B
WB
Zentren für Innere Medizin, Universität Marburg.
Wichtrup
B
B
Maroske
D
D
Rüschoff
J
J
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001064:Appendicitis / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014463:Ultrasonography
Sonographie bei akuter Appendizitis. Eine prospektive Studie.