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J Korean Soc Emerg Med > Volume 6(2); 1995 > Article
Journal of The Korean Society of Emergency Medicine 1995;6(2): 371-380.
A CLINICAL REVIEW OF APPENDICITIS AND CLINICAL VALIDITY OF ULTRASONOGRAPHY
Hyeong Soo Kim, Jeong Bae Park, Hyuk Jun Yang, Seong Youn Hwang, Cheol Wan Park, Keun Lee
Department Of Emergency Medicine, Chung Ang Gil Hospital, lncheon,Korea
  Published online: December 31, 1995.
ABSTRACT
Appendicitis is the most common acute abdomen in Emergency Medical Center & outpatient department. But sometimes, it is difficult for us to diagnose because of clinically variable symptoms. We reviewed the ultrasonographic findings and analyse 521 cases of appendectomy patients about its distribution of sex and age, seasonal prevalence, clinical symptom and signs, laboratory findings, duration from onset of symptom to arrival at hospital, duration from arrival at hospital to operation, vital signs, operative results, and associated diseases, which were treated at the department of General Surgery & Emergency Medical Center in Chung Ang Gil Hospital from July, 1994 to June, 1995. The results were as follows : 1. The most common age group was second decade. And male to female ratio was 1.43:1. Seasonal variation was not significant. 2. Of 521 cases, 141 cases(27.1%) visited the hospital within 24 hours from the onset of symptom, and 259 cases(49.7%) visited between 24 to 48 hours. 3. In duration from arrival to operation, the cases within 6 hours were 263 (50.5%), the cases between 6 and 12 hours were 131(25.1%). 4. In systolic blood pressure, cases below 90mmHg were 19(3.6%), cases above 160mmHg were 23(4.4%). Below 60mmHg diastolic pressure were 55 cases (10.6%), cases above 110mmHg were 9(1.7%). In pulse rate, above rate/min were 171(32.8%). 5. On admission leukocytosis was found in 413 cases(79.3%) and 342 cases of them were pathologic appendicitis. 6. Ultrasoundgraphy was performed in the 87 cases, but 23 cases were suggested appendicitis. Among 23 cases, 22(95.7%) revealed pathologic appendicitis at operation and labortatory examination. Of the 64 cases which were normal on ultrasonography, only 2 cases(3.1%) were proved to be appendicitis. 7. The results of 496 operations without ultrasonography were appendicitis in 390 cases(78.6%), mesenteric lymphadenopathy 36(7.3%), pelvic inflammatory disease 28(5.6%), fecalith 15(3.0%), tenninal ileitis 8(1.6%), diverticulitis 7(1.4%), urinary tract stones 5(1.0%), cecal cancer 2 cases, right ovarian tumor 2 cases, tubo-ovarian abscess 2 cases, greater omentum internal hernia 1 case. Our results showed that the sensitivity of ultrasonohraphy was 95.8% and the specificity 98.4% in the diagnosis of appendicitis. It suggests that the ultrasonography is very helpful in the diagnosis & differential diagnosis of acute appeendicitis.
Key words: Ultrasonography, Appendicitis
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