1994 Volume 55 Issue 11 Pages 2755-2763
To evaluate the availability of Ultrasonography (US) on acute appendicitis, criteria based on the muscle layer of visualized appendix for grading appendicitis such as catarrhal, phlengmonous, and gangrenous appendicitis, was made on three hundred and twelve consecutive patients on whom were performed US with clinically suspected appendicitis. A prospective study was then performed with criteria for surgical intervention, consisted of visualization of phlegmonous or gangrenous appendix and ancillary findings (ascites, typhlitis, suspected abscess formation, and fecalith). US diagnosis for appendi-citis has proved to have an over all accuracy rate of 95.8% and for grading appendicitis 82.6%. The sensitivity of US criteria for surgical intervention was 96.3%, with a specificity of 93.5%. The overall accuracy was 94.2%. There results indicate that US has proved to be of clinical value. In 4 cases of catarrhal appendicitis and one case of unknown peritonitis were treated conservatively under these criteria, surgery was required later. Three children of these 5 cases had perforated peritonitis and two adults of these had not at laparotomy. In conclusion, it is necessary to closely follow up clinical symptoms with US, even on catarrhal cases, and early laparotomy can be justified, especially on some child cases.
