Çocukluk çaği akut ve perfore apandisitlerinde ultrasonografik bulgularin tani değerleri

Abstract

Background and aims: The ultrasonographic (USG) appearances of the appendix and periappendicular regions differ according to the degree of inflammation as well as the presence of perforation in children with acute appendicitis. The aim of this study was to evaluate the diagnostic value of ultrasonographical findings in patients with acute (AA) and perforated appendicitis (PA) with preoperative ultrasonographic investigations and to compare the results with the previously published data. Materials and methods: The material of this study included data regarding the ultrasonographical evaluation of 188 patients treated with the diagnosis of appendicitis in the period January 1997- March 2000. The parameters of USG evaluation were: the appearance of pathological appendiceal mass (A), appendicolith (B), diameter of the appendiceal wall (entire appendix) in mm (C), localized fluid in periappendicular region, pelvis, or Douglas (D), diffuse intraperitoneal fluid (E), findings of ileus (aperistaltic, dilated bowel loops) (F), and normal ultrasonographic findings (G). Appendiceal wall mass was calculated in both groups, and the difference was compared statistically. Results: The distribution of ultrasonographic parameters in each group for a total 188 patients were as follows: (A)61, (B)6, (C)51, (D)16, (E)8, (F)25, (G)20 for acute appendicitis; and (A)42, (B)9, (C)31, (D)29, (E)14, (F)24, (G)10 for perforated appendicitis. The average value for appendiceal wall thicknesses was calculated as 19.37 (±12.55) mm for AA, and 23.80 (±15.10) mm for PA. The difference between the two groups was not statistically significant. Appendiceal wall thicknesses were greater than 6 mm in all patients (81) except one. Intraperitoneal fluid collection was detected in 34.9% of the patients for the PA group. Conclusion: USG is a reliable and non-invasive method in the diagnosis of acute appendicitis; the appearance of ‘mass' bigger than 6 mm in diameter is valuable in diagnosis. The incidence of sonographic findings and the measurement of the appendiceal wall increase in case of perforation. Because there was no important difference between the ileus findings of the two groups, we think it can serve as a useful criterion in the ultrasonographic diagnosis of acute appendicitis.