[Value of ultrasound in diagnosis of acute appendicitis]

Acute appendicitis is one of the most frequent causes of an acute abdomen. The clinical diagnosis is based on the case history and the physical examination which plays a major role in clinical diagnosis. However, in some cases the typical clinical symptoms are equivocal or misleading. Without using the opportunities of diagnostic imaging the accuracy of preoperative appendix diagnosis ranged between 70 and 78%. Consequently the rate of unnecessary laporotomies ranged between 22 and 28%. Since 1986, 13 studies including more than 5,000 patients have been published showing a sensitivity of 85% and a specificity of 96% if the sonographic examination was performed by an experienced examiner. The rate of negative laparotomies could be decreased to 7%, and possible differential diagnoses could be either confirmed or ruled out by using ultrasound technique. Based on the current literature, real-time sonography plays a major part in the diagnosis of acute appendicitis.