Detectability of the normal and acutely inflamed appendix - In patients with right sided abdominal pain.

The detectability, vascularization and size of the normal and inflamed appe ndix were investigated in the study. 148 patients under suspicion of append icitis or with lower right abdominal pain were studied over a period of fiv e months beginning in January 1998. An ultrasound-transducer was employed a t a wave length of 3.5 MHz to 10 MHz. Vascularization was measured using 'D uplex' and 'Color Angio'. The results were compared with operative evidence , histology and patient history. The appendix was detected in about 30% of the cases (47/148). But of the presumably normal appendices only 12%(13/109 ) were detected. 27 appendices sonographically diagnosed as acutely inflame d were confirmed by operation and phlegmonic. The acute appendicitis was so nographically diagnosed with a sensitivity of 82% and a specificity of 95%. The diameter of the normal appendices was an average of 5.5 mm, that of th e acute was 12.2 mm whereby 21 of 25 organs were at least 9 mm. The measure ment of the organ size seems to be more helpful than the detection of vascu larization. Both methods alone cannot detect the acute phlegmonic appendici tis. The normal appendix was less frequently detected than described in cur rent literature. Patients with pain present difficulties in ultra-sound exa mination because both the cooperation and the time for the correct diagnosi s are limited.