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[Ultrasonic diagnosis in appendiceal perforation]
G Meiser1, M Heinerman, O Boeckl
1I. Chirurgische Abteilung Landeskrankenanstalten Salzburg.
Schweizerische Rundschau Fur Medizin Praxis = Revue Suisse De Medecine Praxis
|February 6, 1990
Summary
Clinical assessment alone is superior to ultrasonography for diagnosing appendiceal perforation. Combining clinical and sonographic findings improves diagnostic accuracy for appendicitis and perforation.
Area of Science:
- Medical Imaging
- Surgical Pathology
Background:
- Appendiceal perforation is a critical surgical emergency.
- Accurate diagnosis of appendicitis and perforation is essential for timely intervention.
Purpose of the Study:
- To evaluate the efficacy of clinical assessment, sonography, and their combination in diagnosing appendiceal perforation.
- To compare the diagnostic performance of isolated clinical assessment versus isolated sonography.
Main Methods:
- Prospective study of 154 patients with suspected appendicitis (excluding simple cases).
- Evaluation of clinical assessment, sonography, and combined findings.
- Histologic examination as the gold standard for confirmation.
Main Results:
- Clinical assessment showed high sensitivity (87%) and specificity (97%) for appendicitis, and 74% sensitivity and 97% specificity for perforation.
- Sonography demonstrated 85% sensitivity and 98% specificity for appendicitis, and 69% sensitivity and 98% specificity for perforation.
- Combined assessment improved accuracy for appendicitis (92%) and perforation (80%) compared to isolated methods.
Conclusions:
- Sonography is a valuable adjunct to clinical assessment for appendiceal perforation.
- Clinical assessment alone appears superior to ultrasonography as an isolated diagnostic procedure.