IMPORTANCE OF SONOGRAPHY IN THE DIAGNOSIS OF APPENDICITIS - RESULTS OF THE EAST-GERMAN MULTICENTER STUDY

Based on the East German quality assessment study our investigation wa s aimed to evaluate if sonography has a diagnostic value for the indic ation to appendectomy or if it is only relevant for the differential d iagnosis of acute abdominal pain. In a prospective trial we recorded a nd analysed all sonograms which were obtained in a period of one year at 34 East German hospitals. 3924 patients were examined by ultrasonog raphy. The sex distributions was 1:1.8 on behalf of the female patient s. The correlation of sonogram and intraoperative macroscopic findings showed a high rate (68.2 %) of acute inflamed appendices in cases wit h negative ultrasound results. A positive sonogram with an inflamed ap pendix was confirmed in 90 % of the cases intraoperatively. In our stu dy the routine use of ultrasonography for the diagnosis of acute appen dicitis shows a sensitivity of 21.5 % an a specifity of 80.1 %. The po sitive predictive value is 95.6 % and the predictive value for negativ e results is 9.8 %. In conclusion, if clinical examination shows the p resumptive diagnosis of acute appendicitis, a negative sonogram should not withhold the surgeon to perform an operative intervention.