Rendimiento de la ecografía abdominal en el diagnóstico de apendicitis aguda

Laburpena

Introduction Acute appendicitis (AA) is the first cause of surgical abdomen in childhood but diagnosis continues to be difficult in some cases. Abdominal ultrasonography has been shown to be useful when there is doubt about the diagnosis and can be quickly and easily performed at the patient’s bedside. Objective To evaluate the efficacy of abdominal ultrasonographyin the diagnosis of acute appendicitis in our hospital. Patients and methods All patients who visited the emergency department forabdominal pain and who underwent abdominal ultrasonographyto rule out AA between January 1, 1999 andDecember 31, 2000 were retrospectively studied. Results During the study period, 4217 children were evaluated in our service for abdominal pain. Ultrasonography was performed in 528 children. Of these, the procedure was performed to rule out AA in 308 patients. Of these 308 patients who met the study’s inclusion criteria, the results of ultrasonography were compatible with AA in 102 and were normal in 196. Ultrasonographic diagnosis differed from the final diagnosis in 16 patients. In eight children with ultrasonographic findings suggestive of AA, laparo tomy revealed normal appendices. In the remaining eight patients, ultrasonographic findings were normal and surgery revealed AA. Based on these findings, the diagnostic yield of abdominal ultrasonography was: sensitivity: 96.6%; specificity: 95.9 %, positive predictive value: 86 %; negative predictive value: 95.9%. Conclusions The overall diagnostic yield of abdominal ultrasonographyin AA our hospital is acceptable. Because ultrasonographicdiagnosis is not always accurate, others diagnosticmethods such as computed tomography should be usedin doubtful cases.