Outer Diameter of the Vermiform Appendix as a Sign of Acute Appendicitis: Evaluation at US

Rettenbacher, Thomas; Hollerweger, Alois; Macheiner, Peter; Rettenbacher, Lukas; Tomaselli, Florian; Schneider, Barbara; Gritzmann, N.

doi:10.1148/radiology.218.3.r01fe20757

Cited by 122 publications

(68 citation statements)

References 29 publications

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“…In these cases we confidently excluded the diagnosis of acute appendicitis. This is in conformity with the study of Thomas Rettenbacheret al 7,8 In the remaining 14 cases, ultrasound was unable to detect either normal or abnormal appendix. In 35 cases (62.5 %) of the total number of cases where we could see an inflamed appendix, it was non-compressible and spherical in shape in all the cases.…”

Section: Figure 1: Ultrasonography Of Acute Appendicitissupporting

confidence: 90%

Ultrasonographic (Usg) Evaluation of Acute Appendicitis

Sidhique¹,

Ahmed²

2015

jemds

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BACKGROUND:The diagnosis of acute appendicitis is mainly clinical and to augment the clinical diagnosis ultrasonography (USG) of the abdomen is being used to help in diagnosis of the disease. AIM: To find out the role of USG in the diagnosis of acute appendicitis in clinically equivocal cases and to correlate USG findings with histopathological reports (HPR) of removed appendix. MATERIALS AND METHODS:This study was performed during the period from November 2012 to March 2014.It wasnon-randomized, prospective study of 56 clinically suspected cases of acute appendicitis. All of them underwent ultrasound evaluation. A histopathological examination was performed on all surgically removed appendices, which formed the basis for definitive judgment.Patients not undergoing surgery were excluded for calculating sensitive and specificity. The diagnostic accuracy of sonography was examined using the NPV, positive predictive value (PPV), negative and positive likelihood ratios, sensitivity, specificity, and their respective 95% confidence intervals (CIs). RESULTS: Out of 56 patients, 38 patients were correctly diagnosed as having acute appendicitis on USG out of 47 finally diagnosed cases based on histopathological reports. This showed that USG scan has sensitivity of 89.74%, specificity of 77.78%, positive predictive value of 94.44% and negative predictive value of 87.23%. The most accurate appendiceal finding for appendicitis was a diameter of 6 mm or larger followed by non-compressibility of inflamed appendix. CONCLUSION: USG has high accuracy in diagnosing acute appendicitis and reduces negative appendectomies. Greater than 6-mm diameter of the appendix under compression is the most accurate USG finding with high positive predictive value for the diagnosis of acute appendicitis. Surgery followed by histopathological examination was the ultimate proof of acute appendicitis.

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Section: Figure 1: Ultrasonography Of Acute Appendicitissupporting

confidence: 90%

Ultrasonographic (Usg) Evaluation of Acute Appendicitis

Sidhique¹,

Ahmed²

2015

jemds

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“…[20] In this study, diameter measurement was significantly smaller in LH group compared with other 2 groups. US was useful to differentiate LH from NCAA and CAA.…”

Section: Discussionmentioning

confidence: 43%

How To Avoid Negative Appendectomies: Can Us Achieve This?

Kartal¹

2016

Ulus Travma Acil Cerrahi Derg

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“…The present study is in agreement with that of Jeffrey RB et al 8 who had concluded that a diagnosis of appendicitis can be made in patients with persistent right iliac fossa pain and an appendicular diameter of > 6 mm. Rettenbacher T et al 9 however, noted appendicular diameter in control subjects (who did not have appendicitis) ranged between two to 13 mm and in 23% of these patients the diameter were > 6 mm. Diameter of acutely inflamed appendix ranged from 6 to 30 mm.…”

Section: Discussionmentioning

confidence: 93%

Ultrasonography in acute appendicitis

Prasad

Chhetri

2017

J Coll Med Sci-Nepal

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Background & Objectives:This study was under taken to establish the Ultrasonographic (USG) findings in acute appendicitis and to establish the accuracy of USG in the diagnosis of acute appendicitis. Materials & Methods: One hundr ed patients who pr esented to the emergency department with a clinical diagnosis of acute appendicitis were subjected to USG. USG findings of those patients suggestive of acute appendicitis were noted. The decision to operate for appendicitis was made on the surgeon`s final clinical impression after correlating with USG findings. Histopathological examination of the appendicectomy specimen was taken as the gold standard for the diagnosis of acute appendicitis. Results: USG diagnosis of acute appendicitis is based on a combination of sonographic features. The findings of an aperistaltic tubular structure arising from the caecum with a target appearance on cross section, outer diameter of > 6 mm, mural wall thickness > 3 mm, and probe tenderness over the visualized appendix should prompt the diagnosis in the appropriate clinical settings. The visualization of appendicolith is associated with higher rate of perforation and the visualization of fluid with internal echoes in acute appendicitis could suggest abscess formation. Conclusion: USG is a very useful and essential modality in the diagnosis of acute appendicitis with a sensitivity of 93.93%, specificity of 100%, PPV of 100%, NPV of 89.47% and an overall accuracy of 96% in the diagnosis of acute appendicitis.

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Outer Diameter of the Vermiform Appendix as a Sign of Acute Appendicitis: Evaluation at US

Abstract: The outer appendiceal diameter of 6 mm or more as a sign of acute appendicitis provides high sensitivity but limited specificity. This diagnostic criterion is more useful in excluding acute appendicitis than in confirming it.

Cited by 122 publications

References 29 publications

Ultrasonographic (Usg) Evaluation of Acute Appendicitis

Ultrasonographic (Usg) Evaluation of Acute Appendicitis

How To Avoid Negative Appendectomies: Can Us Achieve This?

Ultrasonography in acute appendicitis

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