[Value of ultrasound in diagnosis of appendicitis. Results of the East German Multicenter Study. East German Working Group "Outcome Assessment and Quality Assurance in Surgery" of the CAQ of the German Society of Surgery].
Based on the East German quality assessment study our investigation was aimed to evaluate if sonography has a diagnostic value for the indication to appendectomy or if it is only relevant for the differential diagnosis of acute abdominal pain. In a prospective trial we recorded and analysed all sonograms which were obtained in a period of one year at 34 East German hospitals. 3924 patients were examined by ultrasonography. The sex distributions was 1:1.8 on behalf of the female patients. The correlation of sonogram and intraoperative macroscopic findings showed a high rate (68.2%) of acute inflamed appendices in cases with negative ultrasound results. A positive sonogram with an inflamed appendix was confirmed in 90% of the cases intraoperatively. In our study the routine use of ultrasonography for the diagnosis of acute appendicitis shows a sensitivity of 21.5% an a specificity of 80.1%. The positive predictive value is 95.6% and the predictive value for negative results is 9.8%. In conclusion, if clinical examination shows the presumptive diagnosis of acute appendicitis, a negative sonogram should not withhold the surgeon to perform an operative intervention.
Marusch
F
F
Chirurgische Klinik Carl-Thiem-Klinikum, Cottbus.
Allecke
K
K
Gastinger
I
I
D001062:Appendectomy; D001064:Appendicitis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D001065:Appendix / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D019564:Unnecessary Procedures