Utilidad de la ecografía abdominal en los cuadros dolorosos agudos de la fosa ilíaca derecha con sospecha de apendicitis aguda: Experiencia del Hospital Maciel

Pablo Dibarboure; Pablo Sciuto; Fernando Machado; José Luis Rodríguez Iglesias

Authors

Pablo Dibarboure Universidad de la República, Facultad de Medicina, Clínica Quirúrgica 2. Ex Residente de Cirugía
Pablo Sciuto Universidad de la República, Facultad de Medicina, Clínica Quirúrgica 2. Residente de Cirugía
Fernando Machado Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Departamento de Emergencia, Profesor Adjunto. Hospital Maciel, Departamento de Emergencia, Coordinador
José Luis Rodríguez Iglesias Universidad de la República, Facultad de Medicina, Clínica Quirúrgica 2. Profesor Director

Keywords:

ULTRASONOGRAPHY, APPENDICITIS, ABDOMINAL PAIN

Abstract

Introduction: acute appendicitis is one of the most frequent causes of consultation and of indication of emergency laparotomy in most western countries. Despite its diagnostic being based mainly on clinical examination, there is a certain percentage of patients whose clinical presentation is atypical. In these cases image methods such as the abdominal ultrasound are particularly useful as diagnostic auxiliaries.
Objectives: we conducted a prospective study with the objective of assessing the usefulness of this image method in our hospital, and studied 80 patients who consulted the emergency service with episodes the were compatible with acute appendicitis.
Method: we compared the echographic findings with the anatomopathological diagnosis, calculating the sensitivity, specificity and the positive and negative predicting values of the method, discriminated by sex and by technician. We compared these results with the results obtained in other series.
Results: echographies had a rate of false negatives of 33.75% (27/80). Global method sensitivity was 45.5% and the negative predicting value was 15.6%.
Conclusions: we concluded that for the time being, this is not a reliable diagnostic tool to discard appendicitis; it may me useful when findings are positive since positive predictive values are acceptable.

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