[Indications for appendectomy from the ultrasound-clinical viewpoint]

Abstract

From 1.1.1993 to 30.9.1997 1149 patients with right-sided abdominal pain were examined by an experienced sonographer. The specificity of the sonographic diagnosis of acute appendicitis was 98.7%, sensitivity 95.6%, PPV 96.5%, NPV 98.3%, OA 97.8%. The negative laparotomy rate in 1996 was 5.4% (appendix not inflamed by histological examination), perforation rate 11.5%. 25 wrong sonographic diagnoses were made. Out of 530 Patients examined 1995 and 1996 181 alternative diagnoses could be made by ultrasonography. Under not corresponding clinical and sonographic results patients were observed in hospital and clinical and sonographic examination were repeated within 6 hours. Under definite positive sonographic result and questional clinical result operation was preferred. Under recurrent attacks of abdominal pain diagnostic laparoscopy was recommended. Sonographic diagnosis of right sided abdominal pain helped to reduce the risk of restricted indication for diagnostic laparoscopy respectively appendectomy by reducing the number of unnecessary operations without relevant change of perforation rate.