[Sonography in the diagnosis of appendicitis--a prospective study]

In a prospective study the significance of ultrasonography in the diagnosis of appendicitis was evaluated. On 104 patients--57 women and 47 men between the ages of 5 and 88 years--with a preliminary diagnosis of acute appendicitis, ultrasonography was performed using a graded compression technique with small curved-array transducers following physical examination. In 32 of 36 patients with operatively confirmed appendicitis the inflamed appendix could be visualized clearly. All 6 perityphlitic abscesses and 4 of 5 perforations were detected correctly by ultrasonography. In 18 patients the use of sonography led to important differential diagnoses other than appendicitis, which in 4 cases required surgery. By direct visualization of the inflamed appendix and its periappendicidal complications the clinical diagnosis of acute appendicitis can be improved. As a result of sonographic detection or exclusion of other diseases, ultrasonography facilitates the--often difficult--clinical differential diagnosis of right lower abdominal pain.