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Paper Information

Journal:   THE JOURNAL OF URMIA UNIVERSITY OF MEDICAL SCINCES   Winter 2000 , Volume 11 , Number 4; Page(s) 284 To 291.
 
Paper: 

DIAGNOSIS OF ACUTE AND COMPLICATED APPENDICITIS WITH THE HELP OF SONOGRAPHY

 
 
Author(s):  SABER A.A.H.*
 
* SURGERY GUILAN UNIVERSITY OF MEDICAL SCIENCES
 
Abstract: 

Acuate appendicitis is the most common commonest abdominal emergency. The Accuracy of clinical diagnosis is 75% to 78%, which is even lower. In children female adolescents. Consequently, the rate of unnecessary laparatomy increases.
The aim of this study is accurate diagnosis and to prevent the accurance of acute appendicitis as well as to avoid unnecessary laparatomy, we use sonography for available preparatory diagnosis achievement.
During one year 1388, 430 patients, 258 (60%) female and 170 (40%) male within the age range of 2075 year were studied prospectively including clinical history, physical examination and implementation of sonography. Sonography was able diagnose appendicitis with a sensitivity of 89/4%, specify 98.2% and a total accuracy 93.6%. A prediction of, false positive and false negative value was 93.6% and 97% respectively.
Routine sonography before management decision has decreased the unnecessary laparoyomyrate from 20.3 to 11.3%.
In 24.7% of 97 confirnned cases of acute appendiatis rupture of appendix was observed on laparatomy. Only 15 (62%) of these 24 perforated appendicitis were highly suspected on hystory and clinical examination basis 5 (20.7%) were undetermimmante and 4 (17.3%) weakly suspicious, 48% of perforated appendicitis had WBC more than 13000 mm3 and fever of 38 C or above was found in 50% cases. In conclusion sonography was capable to detect the inflamed appendix complicated with abces formation or a perforation in 22 (91.7%) of 24 cases. The high incidence (24.4%) of complicated appendicitis among 97 acute cases of this study suggests delayed approach due to lack of clinical diagnosis.

 
Keyword(s): INFLAMMED APPENDIX, PERFORATED APPENDIX, ABSESS, ULTRA SONOGRAPHY
 
References: 
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