This is a clinical analysis of 227 appendectomy patients at the Inha hospital during 8 months from January 1990 to August 1990. A ultrasonographic group, 121 patients, were compared with the other group, 106 patients, those who were diagnosed by
conventional methods without ultrasonography. The accuracy of ultrasonographic diagnosis is compared with conventional methods.
@ES The results are s follows ;
@EN 1) On admission, nausea and vomiting were found in 63.4% of the patients. Classic abdominal pain(epigastric pain migrating to right lower quadrant subsequently) were confirmed in 69.1% of the patients.
2) On admission, 99.5% of the patients had right lower quadrant tenderness, but rebound tenderness 80.1%.
3) Leukocytosis(>10.000/㎣) were present in 81.5% of the patients.
4) In the final histopathological diagnosis; appendicitis with fecalith 14 cases(6.1%), suppurative appendicitis 119 cases(52.4%), gangrenous appendicitis 23 cases(10.1%), perforated appendicitis 28 cases(12.3%), periappendiceal abscess 5
cases(32.2%),
and 38(16.7%) appendices were normal
5) The overall diagnostic accuracy was 83.2%. The ultrasonographic group showed 81.8% of sensitivity, 54.5% of speicificity, and 72.4% of accuracy. But the non-ultrasonographic group showed 84.5% of diagnostic accuracy. This difference was not
statistically significant(Chisquare test, p>0.05).
6) In the patients those had non-classic symptom and physical findings, the ultrasonographic group, 58 cases, showed 73.9% of sensitivity, 66.6% of speicificity and 73.9% of accuracy. But the non-ultrasonographic group showed 79.2$|% of
diagnostic
accuacy. This difference was statistically insignificant(Chi-square test, p>0.05).
We confirmed ultrasonographic examination for early diagnosis and differential diagnosis of acute appendicitis is no longer valid in our institute than the conventional diagnostic methods such as history taking and physical examination unless
advancing
of the ultrsonographic technique.
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