3009: Ultrasound diagnosis of the patients with right lower quadrant abdominal pain

Abstract

Objectives: We present experience of our own in diagnosing appendicitis with the aim to reduce the number of negative laparotomies and the appendiceal perforation which result from delayed diagnoses. Methods: The graded compression technique of Puylaert was used, which gives direct visualization of the appendix by using the 5 or 7,5 MHz linear array transducer. Results: Two hundreds patients were examined with right lower quadrant abdominal pain, suspected for appendicitis. Appendicitis was found in 82 (41%) of the patients. These findings were confirmed by laparotomy. US finding of appendicitis were not present with 118 (59%) of the patients. In 47(39,8%) of them was not possible to make definitive diagnosis. Additional examinations were done in 17 patients: plain abdominal (five), barium enema (five), CT (seven) and MRI (two). Conclusions: The graded compression technique enabled us to image appendicitis in vast number of cases. US diagnosis of appendicitis offers vast opportunities in determining atypical forms of presentation of disease and its differential diagnosis. In differential diagnosis can be point two groups of patients: lymphadenitis mesenterialis and ovarian cyst.