Henan Medical Information 2 Discussion Acute appendicitis is one of the most common acute abdomen diseases in surgery. Its pathological development can be divided into three types: simple, cellulitis, and gangrene. Perforation of gangrene is prone to cause diffuse peritonitis. Diagnosis depends mainly on clinical experience. Traditional imaging techniques such as abdominal X-ray and barium enema are usually not helpful in diagnosis. According to foreign data reports, due to clinical diagnosis of appendicitis in patients undergoing surgery, the results of negative patients accounted for 20% to 40%. On the other hand, due to the patient's symptoms are not typical, due to delayed diagnosis and even appendicitis with perforation and peritonitis is not rare | 1. Ultrasonography is the easiest method for diagnosing acute appendicitis. It has become an effective diagnostic method in the evaluation of acute appendicitis, diagnosis of complications such as perforation, and differential diagnosis, which is favorable to the choice of surgical indications and conservative treatment. It is an effective means for diagnosis and differential diagnosis of the ileocecal disease.
5 ± 1.0 mm) ultrasound is not easy to display, but the use of high-resolution ultrasound probe frequency 5 step pressure scanning technology can rule out intestinal gas interference, which is conducive to show inflammatory appendix. The position of the appendix is ​​not constant, and the entire right lower abdomen must be scanned. If necessary, a coronal scan of the right abdomen is performed to prevent the high appendix disease from being missed.
Ultrasound diagnosis of acute appendicitis is based on the discovery of the enlarged appendix, while there is a local probe tenderness, but the appendix imaging and the size of the appendix and the location of the appendix, due to the small appendix and gas interference by the bowel, ultrasound Prone to false negatives. Therefore, for patients with obvious clinical symptoms and signs, the disease can not be denied when the ultrasound diagnosis is negative. 121. When the ultrasound examination, the inflamed appendix should be differentiated from the liquid filled bowel: both are hypoechoic, but the internal diameter of the intestine Larger, easier to compress when the probe is pressurized, easier to recover when the pressure is removed, peristaltic and ring-shaped folds are also observed, inflamed appendix does not have these features, especially the lack of prone to compression when the probe is pressurized | 3). In addition, it should be differentiated from the ileocecal tumor and the right accessory disease of the female, and false positives will not appear when the image is correctly read and read correctly.
Through clinical comparison, we found that except for appendixes with particularly abnormal locations and sizes, patients with acute simple appendicitis were not surrounded by exudates or without fecal stones or without omentum packages. When the enlargement was not significant, the ultrasound detection rate was low. Cellulitis and gangrenous appendicitis have a high coincidence rate with ultrasound examinations, especially for the presence or absence of positive perforation and peripheral abscess formation. The positive rate is about 93%. It has important guiding significance for the clinical choice of treatment, and it is also impossible for other examinations. Replacement. Therefore, preoperative ultrasound examination is very necessary for patients who are clinically diagnosed as acute appendicitis.
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