05 Jun

The role of radiological imaging in the diagnosis of acute appendicitis: ULTRASONOGRAPHY Part 6

Another fundamental weakness of most ultrasonography studies is the failure to address inconclusive test results adequately. Sometimes, the failure to visualize the appendix is regarded as evidence against the diagnosis of appendicitis; however, this assumption may not be valid. In other studies, inconclusive results (such as an appendix of 5 to 7 cm in diameter) […]

04 Jun

The role of radiological imaging in the diagnosis of acute appendicitis: ULTRASONOGRAPHY Part 5

A shortcoming that is common to all of these investigations is the failure either to apply strict histological criteria for the diagnosis of appendicitis or to estimate the interobserver variability for pathologists or for the radiologists. Variability in the histological criteria can affect the sensitivity and specificity of the tests. Moreover, entry criteria are often […]

03 Jun

The role of radiological imaging in the diagnosis of acute appendicitis: ULTRASONOGRAPHY Part 4

Many investigators have studied the diagnostic accuracy of ultrasonography for patients suspected of having appendicitis. Some of the largest and best designed of the prospective studies are summarized in Table 4. In most cases, graded compression technique was used, but the use of pelvic ultrasonography was usually not discussed specifically. Diagnostic accuracy seems to be […]

02 Jun

The role of radiological imaging in the diagnosis of acute appendicitis: ULTRASONOGRAPHY Part 3

In most normal appendices, ultrasonography can demonstrate an echogenic layer (arising from the submucosa) surrounded by a hypoechoic layer (the muscularis propria). In some cases, additional luminal, epithelial, subep-ithelial and serosal structures can be identified and give rise to a ‘target’ appearance. The definition of these layers, especially that of the echogenic submucosal layer, is […]

01 Jun

The role of radiological imaging in the diagnosis of acute appendicitis: ULTRASONOGRAPHY Part 2

Some of these limitations have been circumvented by using graded compression, a technique by which the transducer is applied with gradually increasing pressure to the area of McBurney’s point. Continuous, steadily increasing pressure from the transducer, unlike intermittent application of the device, is tolerated relatively well by patients with acute appendicitis. Gas artifacts are reduced, because […]

31 May

The role of radiological imaging in the diagnosis of acute appendicitis: ULTRASONOGRAPHY Part 1

The usefulness of ultrasonography in the diagnosis of appendicitis has been known since the early 1980s. It is safe (including during pregnancy) and relatively inexpensive, and can be performed quickly and repeatedly, using portable equipment. The patient can indicate the point of maximal tenderness, to which the transducer can be applied. This can facilitate the […]

30 May

The role of radiological imaging in the diagnosis of acute appendicitis: BARIUM ENEMA

The diagnosis of acute appendicitis by barium enema examination is based on nonfilling of the inflamed appendix and on the presence of an extrinsic defect in the wall of the cecum, due to appendiceal and periappendiceal inflammation. The examination can result in complications, however, including perforation, and its diagnostic accuracy is variable and often poor. […]

29 May

The role of radiological imaging in the diagnosis of acute appendicitis: PLAIN ABDOMINAL X-RAYS

Except for the presence of an appendicolith (fecalith) and possibly of a sentinel loop, the findings of acute appendicitis on plain radiographs (Table 2) are nonspecific and generally appear only in advanced disease. Appendico-lithiasis is said to be the most specific of the common findings of appendicitis but is identified in only 10% to 15% […]

28 May

The role of radiological imaging in the diagnosis of acute appendicitis

Appendicitis is a common and important clinical problem that afflicts 8.6% of male and 6.7% of female Americans. There are 250,000 to 300,000 appendectomies, including 60,000 to 80,000 involving children, and more than one million patient-days of hospitalization for appendicitis, each year in the United States. There are problems with the current methods of diagnosis, […]

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