Vaida Ruseckaitė1, Vytautas Dūdėnas1
Lithuanian university of health sciences, faculty of medicine,
Kaunas, Lithuania
ABSTRACT
Introduction: acute appendicitis is often the diagnosis in patients who are suffering from acute abdominal pain. Quite often, it is complicated to detect this ailment based only on the patient’s medical history, physical examination and laboratory findings. The use of imaging modalities is essential to confirm the diagnosis. Ultrasonography (US) is usually the first-line imaging examination which is performed when acute appendicitis is suspected. The main advantage of US is the absence of ionizing radiation, which is important in the young adult and pediatric populations, among which appendicitis usually occurs and who are very vulnerable to the radiation.
Aim: to review scientific literature and determine guidelines for imaging acute appendicitis using ultrasonography.
Materials and methods: literature analysis. A research of articles in English language on the “PubMed” 2011 to 2017 database. Keywords used in the search: “Acute appendicitis”, “Ultrasonography”, “Guidelines”.
Results: the clinical diagnosis of acute appendicitis remains difficult, both in the pediatric and adult population, as the presentation is often atypical. Symptoms are frequently non-specific and overlap with various other diseases. The reported sensitivity for US varies in the literature (67–100%) and is lower than computed tomography (CT). Despite the variety in the sensitivity, the reported specificity of US is 95–98%, which is almost equal to the specificity of CT
Conclusions: the use of US as an initial imaging technique can help reduce the rate of negative appendectomies and minimize radiation hazards by limiting the use of CT, especially in pediatric patients. CT is recommended only in patients with negative or inconclusive US findings.
Key words: appendicitis, ultrasonography, guidelines.