[The echographic diagnosis of acute appendicitis and its complications]

The authors report their experience with emergency US in patients hospitalized for clinical suspicion of acute appendicitis or presenting with pain in the right lower abdominal quadrant. One hundred fifty-two patients were examined with US: 93/152 had pathologies of the right iliac region; 81 of them underwent surgery (50/81 appendectomies). In 27 of these patients the inflamed appendix presented with a typical US pattern. All of them had surgical confirmation. In 13/50 cases, US findings followed an atypical pattern (6 patients had a periappendiceal mass in the right iliac region, 3 had small amounts of fluid in the Douglas pouch, and 4 had gas-filled bowel loops of the ileum). The false negatives were 10/50. US sensitivity was 80%, and its specificity was 54%. The most common pathologic conditions are described whose symptoms mimic those of acute appendicitis. US role in inflamed acute appendicitis is still to be defined. Nonetheless, the authors suggest that US be performed on all patients with atypical pain in the lower abdominal quadrants, because of its high diagnostic accuracy in many common pathologies mimicking appendicitis, especially urinary and uterine adnexal pathologies.