[The value of ultrasound in the diagnosis and management of acute appendicitis].
Acute appendicitis represents the most frequent cause of surgical acute abdomen in emergency units. The incidence of misdiagnosis due to non-therapeutic interventions, other diagnoses that explain the pain or late interventions for complicated appendicitis are still very high.Our study aims to determine the validity and safety of the diagnostic evaluation and helps in decision-making for ultrasound in acute appendicitis in light of statistical evaluation of diagnostic tests.During 2005 and 2006, all patients that went to the emergency room with abdominal pain with suspicion of acute appendicitis were evaluated clinically with laboratory tests and ultrasound. They were classified into three groups due to the suspicion of appendicitis: A. Immediate surgery, B. In-hospital observation and C. Out-patient observation. Out of 114 patients observed, 99 underwent operation, with anatomo-pathologic diagnosis of appendicitis in 92 of them. The sensitivity of the ultrasound in terms of certainty and suspicion was 62.7%. The positive probability quotient for the ultrasound certainty for appendicitis was higher than 10, which indicated a strongly positive result for the test. We demonstrated that the abdominal ultrasound for diagnosis and decision-making in acute appendicitis is useful in all cases, even more in the cases of diagnostic doubt, with unclear clinical presentation and laboratory results.
Velásquez Hawkins
Carlos
C
Cirujano General y Laparoscopía de la Clínica San Gabriel
Aguirre Machado
Wilder
W
Valdivia Béjar
Carlos
C
Ruiz Adarmes
Mario
M
Cornejo Mozo
Carlomario
C
Torres Cava
Martín
M
Cerna León
Jorge
J
Carrasco Oré
Antonio
A
D000328:Adult; D001064:Appendicitis / Q000000981:diagnostic imaging* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography