闌尾炎之超音波診斷

Sonographic Diagnosis of Appendicitis

梁宏志(Hong-Jung Liang) ； 連振東(Jenn-Dong Lian) ； 蔡宏名(Hong-Ming Tsai) ； 鄭莉莉(Li-Li Cheng) ； 姚維仁(Wei-Jen Yao)

《中華放射線醫學雜誌》 20卷2期 (1995/06) Pp. 147-153

摘要

為了評估臨床上，以高解析度超音波診斷闌尾炎之情形，我們採回溯性研究法，選取自1988年10月至1993年11月，臨床難以診斷而經超音波診斷為闌尾炎之病人共32位，按開刀的有無分為兩組，各21人及口人。接受開刀組病人，經開刀及病理切片證實為闌尾炎者為17人(81%)，其他4人(19%)各為腎病症候群合併腹水，末端迴腸炎，盲腸憩室破裂及胃癌術後合併腸阻塞。未接受開刀組之病人，4人無法追蹤，其餘7人中，6人(86%)經追蹤檢查後符合闌尾炎之診斷（7人均接受電腦斷層攝影檢查，其中接受第二次超音波檢查有2人，下消化道攝影和超音波導引穿刺引流者各一人），另l人則不符合，是為骨盆腔炎合併卵巢炎。因此臨床上難以判定為闌尾炎之病例，藉助於一位有經驗的醫師施行超音波檢查可得到很好的鑑別診斷。

關鍵字

闌尾炎 ； 闌尾，膿瘍 ； 闌尾，超音波

並列摘要

To evaluate the accuracy of sonographic diagnosis of acute appendicitis, 32 patients diagnosed as appendicitis or appendiceal abscess by ultrasound from October 1988 to November 1993 in this Hospital were reviewed retrospectively. Of those patients in this study, 21 underwent surgical treatment, and 17 (81%) of the operated patients were proved to have appendicitis or appendiceal abscess. The other four patients were proved to have cecal diverticulitis with rupture, terminal ileitis, nephrotic syndrome with ascitis, and gastric cancer status post operation with ileus, respectively. Among the 11 patients treated nonsurgically, 4 were lost to follow up. Six of the other seven patients (86%) were proved to have appendicitis or appendiceal abscess by other modality, including computed tomography in seven patients, another ultrasound examination in two, lower GI series study in one, and one had ultrasound-guided drainage of the appendiceal abscess. One patient was proved to have pelvic inflammatory disease and oophoritis.
It was concluded that ultrasound evaluation of the appendix is a valuable modality in clinically difficult cases of suspected acute appendicitis.

並列關鍵字

Appendicitis ； appendix, abscess ； appendix, ultrasound