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Value of US in excluding acute appendicitis

  • Ultrasonography
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Abstract

A positive US finding can prevent further delay of the diagnosis of acute appendicitis (AA), but what is the value of a negative test? A US examination of the whole abdomen was performed in 279 patients clinically suspected of having appendicitis. In 86 of the 279 patients who had no evidence of appendicitis sonographicallym we tried to exclude appendicitis by an added effort to find the normal appendix or a condition mimicking AA. Of these 86 patients, 44 had another disease confirmed sonographically. The normal appendix was visible in 53 cases. Using the combination of these signs appendicitis could be excluded in 66 cases (76%). None of the ultrasonographically visualised normal appendices proved to be inflamed surgically. In 5 cases differential pathology coexisted with appendicitis. The best way of excluding AA is the visualisation of the normal appendix in its whole length, which was possible with forced search in 62% of cases.

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References

  1. Jeffrey JB (1991) Acute appendicitis: the radiologist's role. Radiology 180: 13

    Google Scholar 

  2. Chipponi J, Pezet D (1992) Les examens complementaires dans les appendicities aignes. Rev Prat 42: 689

    Google Scholar 

  3. Puylaert JBCM (1986) Acute appendicitis: US evaluation using graded compression. Radiology 158: 355

    CAS  PubMed  Google Scholar 

  4. Jeffrey RB Jr, Laing FC, Lewis FR (1987) Acute appendicitis: high resolution real-time US findings. Radiology 163: 11

    Google Scholar 

  5. Abu-Yousef MM, Bleicher JJ, Maher JW, Urdaneta LF, Franken EA Jr, Metcalf AM (1987) High resolution sonography of acute appendicitis. AJR 149: 53

    Google Scholar 

  6. Jeffrey RB Jr, Laing FC, Townsend RR (1988) Acute appendicitis: sonographic criteria based on 250 cases. Radiology 167: 327

    Google Scholar 

  7. Vignault F, Filitrault D, Brandt ML, Garel L, Grignon A, Ouimet A (1990) Acute appendicitis in children: evaluation with US. Radiology 176: 501

    Google Scholar 

  8. Puylaert JBCM (1990) Ultrasound of appendicitis and its differential diagnostic. Springer, Berlin Heidelberg New York

    Google Scholar 

  9. Shinbrot RG, Miller HR (1992) Ultrasonographic evaluation of acute appendicitis. J Am Osteopath Assoc 92: 90

    Google Scholar 

  10. Sivit CJ, Newman KD, Boenning DA, Nussbaum-Blask AR, Bulas DI, Bond SJ, Attori R, Rebolo LC, Brown-Jones C, Garin DB (1992) Appendicitis: usefulness of US in diagnosis in a pediatric population. Radiology 185: 549

    Google Scholar 

  11. Larson JM, Peirce JC, Ellinger DM, Parish GH, Hammond DC, Ferguson CF, Verde FJ, Vander Kolk HL (1989) The validity and utility of sonography in the diagnosis of appendicitis in the community setting. AJR 152: 687

    Google Scholar 

  12. Madwed D, Mindelzun R, Jeffrey RB Jr (1992) Mucocele of the appendix: imaging findings. AJR 159: 69

    Google Scholar 

  13. Bober SE, Cohen HL, Setzen G, Garenanni C (1992) Rectus sheath hematoma simulating periappendiceal abscess. J Ultrasound Med 12: 175

    Google Scholar 

  14. Puylaert JBCM (1992) Right-sided segmental infarction of the omentum: clinical, US, and CT findings. Radiology 185: 169

    CAS  PubMed  Google Scholar 

  15. Ghabremani GG, White EM, Hoff FL, Gore RM, Miller JW, Christ ML (1992) Appendices epiploicae of the colon: radiologic and pathologic features. Radiographics 12: 59

    CAS  PubMed  Google Scholar 

  16. Poelman JG, Hüpsher DN, Ritsema GH (1991) Sonographic manifestation of an inflamed Meckel's diverticulum: a case report. Eur J Radiol 12: 45

    Google Scholar 

  17. Rubin GD, Jeffrey RB Jr (1992) Graded compression sonography of abdominal neoplasms mimicking acute appendicitis. Gastrointest Radiol 17: 292

    Google Scholar 

  18. Seelen JL, Ho Kang You PH, Vries AC de, Puylaert JBCM (1992) Eosinophilic enteritis presenting as acute abdomen: US features of two cases. Gastrointest Radiol 17: 19

    Google Scholar 

  19. Gaensler EHL, Jeffrey RB, Laing FC, Townsend RR (1989) Sonography in patients with suspected acute appendicitis: value in establishing alternative diagnoses. AJR 152: 49

    Google Scholar 

  20. Zielke A, Malewski U, Lindlar R, Förster R, Klotter HJ, Rüshoff J, Sitter H, Rothmund M (1991) Sonographie bei Verdacht auf akute Appendicitis: Möglichkeit oder Notwendigkeit für den Chirurgen? Chirurg 62: 743

    Google Scholar 

  21. Evens RG (1991) Ultrasonography of acute abdominal pain children. JAMA 266: 1987

    Google Scholar 

  22. Simonovski V (1992) Acute appendicitis: the false-positive observations prospective diagnosis — value of the “rod” sign. Eur Radiol 2: 511

    Google Scholar 

  23. Hayden CK, Kuchelmeister J, Lipscomb TS (1992) Sonography of acute appendicitis in childhood: perforation versus non-perforation. J Ultrasound Med 11: 209

    Google Scholar 

  24. Rioux M (1992) Sonographic detection of the normal and abnormal appendix. AJR 158: 773

    Google Scholar 

  25. Vu Nghiem H, Jeffrey RB Jr (1992) Acute appendicitis confirmed to the appendiceal tip: evaluation with graded compression sonography. J Ultrasound Med 11: 205

    Google Scholar 

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Correspondence to: Z. Tarján

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Tarján, Z., Weszelits, V. Value of US in excluding acute appendicitis. Eur. Radiol. 5, 538–542 (1995). https://doi.org/10.1007/BF00208349

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  • DOI: https://doi.org/10.1007/BF00208349

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