Avtor/Urednik		Vegar-Zubović, Sandra; Lincender, Lidija; Dizdarević, Salahudin; Sefić, Irmina; Dalagija, Faruk
Naslov		Ultrasound signs of acute appendicitis in children - clinical application
Prevedeni naslov		Ultrazvočne značilnosti akutnega vnetja slepiča pri otrocih
Tip		članek
Vir		Radiol Oncol
Vol. in št.		Letnik 39, št. 1
Leto izdaje		2005
Obseg		str. 15-21
Jezik		eng
Abstrakt		Background. Acute appendicitis is a leading cause of the abdominal pain in children that need an urgent surgical treatment. Neither of individually clinical variables doesn't have a real discriminational nor predictive strength to be used as the only diagnostic test. Agoal of this study is to define ultrasound criterta of the acute appendicitis by appointing of ultrasound parameters for this pathological condition, determine the relation between ultrasound signs and pathohistological finding, determine the connection of several ultrasound signs with a degree of the inflammation of the acute appendicitis. Methods. In the prospective study with an ultrasound method we examine 50 patients with clinical signs of the acute abdomen. In these patients, the sonographic diagnosis is confirmed by the surgical finding, in factwith a pathohistological diagnosis. A basic, positive sonograph finding of the acute appendicitis was the identification of tubular, noncompresive, aperistaltic bowel which demonstrates a connection with coecum and blind terminal. In our work we analysed the lasting of the symptoms until the hospital intervention in patients stratified according to the pathohistological finding. We used ultrasound equipment- Toshiba Sonolayer with convex 3.75 MHz and linear 8 MHz probes. Results. From 8 ultrasound signs of the acute appendicitis, only an anterior-posterior (AP) diameter of appendices, FAT (width of periappendicular fat tissue) and a peristaltic absence are positive ultrasound signs of the acute appendicitis. Appendicitis phlegmonosa is the most common pathohistological finding in our study (44%). Perforate gangrenous appendicitis and gangrenous appendicitis are represented in more than half of patients (30% + 22%), which suggests a long period of persisting symptoms until a hospital treatment. (Abstract truncated at 2000 characters).
Izvleček		Izhodišča. Najpogostejši vzrok bolečin v trebuhu pri otrocih, ki zahteva kirurško obravnavo, je akutno vnetje slepiča. Nobeden od kliničnih znakov nima absolutne diagnostične in napovedne vrednosti. Namen naše raziskave je bil opredeliti ultrazvočne značilnosti akutnega vnetja slepiča ter jih povezati s patomorfološkimi izvidi in intenzivnostjo vnetja. Metode. V prospektivni raziskavi smo ultrazvočno pregledali 50 otrok z znaki akutnega abdomna. Pri vseh bolnikih smo ultrazvočno diagnozo potrdili kirurško in patohistološko. Zanimalo nas je ali se trajanje simptomov do bolnišnične obravnave razlikuje glede na patohistološki izvid. Pri raziskavi smo uporabljali Toshiba Sonolaver ultrazvok s 3,75 MHz konveksno in 8 MHz linearno sondo. Rezultati. Od 8 ultrazvočnih znakov akutnega vnetja slepiča so se zanesljivi pokazali le anteriorno-posteriorna debelina slepiča, debelina periapendikularnega maščobnega tkiva in odsotnost peristaltike. Najpogostejši patohistološki izvid je bilo flegmonozno vnetje slepiča (44%). Pri več kot polovici bolnikov smo odkrili perforirano gangrenozno vnetje slepiča (30%) ali samo gangrenozno vnetje (22%), kar kaže na dolg časovni interval trajanja simptomov pred bolnišnično obravnavo. Statistična analiza je pokazala možnost ocenjevanja stopnje vnetja z anteriorno-posteriorno debelino slepiča in debelino periapendikularnega maščobnega tkiva kot znakoma zadebelitve stene črevesa. Zaključki. Ultrazvočna preiskava je metoda izbire, kadar ob klinični preiskavi dvomimo, ali ima otrok akutno vnetje slepiča. Z anteriorno-posteriorno debelino slepiča, debelino stene in debelino periapendikularnega maščobnega tkiva lahko zanesljivo ultrazvočno ocenimo stopnjo intenzivnosti vnetja slepiča.
Deskriptorji		APPENDICITIS CELLULITIS GANGRENE INTESTINAL PERFORATION CHILD ACUTE DISEASE PROSPECTIVE STUDIES