Publication | Closed Access
A Prospective Study of Ultrasonography in the Diagnosis of Appendicitis
39
Citations
0
References
1988
Year
Medical UltrasoundDiagnosisThoracic UltrasoundSurgeryPeter B.Joep P. J.BiostatisticsProspective StudyRadiologyHealth SciencesMedical ImagingAbdominal ImagingMusculoskeletal UltrasoundInterdisciplinary StudiesUltrasoundEndoscopic DiagnosisHumanitiesPerformance StudiesRoy I.Medicine
The diagnosis of appendicitis is frequently difficult. The study prospectively evaluated the diagnostic accuracy and clinical impact of abdominal ultrasonography in 111 patients suspected of appendicitis. Ultrasound was performed using small high‑resolution linear‑array transducers with abdominal compression to displace or compress bowel and fat. Ultrasound correctly identified appendicitis in 75% of confirmed cases (specificity 100%) and altered management in 26% of patients, including accurate diagnosis of non‑appendicitis conditions, though sensitivity was lower for perforated appendicitis yet did not affect clinical decisions. Published in N Engl J Med 1987; 317:666–9.
The diagnosis of appendicitis is frequently difficult. We studied prospectively the diagnostic accuracy and clinical impact of abdominal ultrasonography in 111 consecutive patients thought to have appendicitis. Ultrasonography was performed with small high-resolution, linear-array transducers, with the abdomen compressed to displace or compress bowel and fat. Among 52 patients later shown in surgery to have appendicitis, ultrasonography was unequivocally positive in 39 (sensitivity, 75 percent). Of 31 patients in whom appendicitis was definitely excluded, none had a positive ultrasound examination (specificity, 100 percent). The sensitivity in those with a perforated appendix (28.5 percent) was much lower than in those with acute nonperforating appendicitis (80.5 percent) or appendiceal mass (89 percent), but the low sensitivity did not influence clinical management, since the need for surgery in patients with a perforated appendix was clinically obvious. Ultrasonography resulted in changes in the proposed management in 29 of the 111 patients (26 percent). It also led to the correct diagnosis in the 16 patients who were found to have a disease other than appendicitis. We conclude that ultrasonography is a useful aid in the diagnosis of appendicitis. (N Engl J Med 1987; 317: 666–9.)