Year 2015 Vol. 23 No 2

GENERAL AND SPECIAL SURGERY

R.R. KASIMOV 1, A.S. MUKHIN, 2, D.A. ELFIMOV 1, A.M. SHELEH 1, A.I. MAKHNOVSKY 3

ULTRASOUND DIAGNOSTICS OF ACUTE APPENDICITIS

FSPE "422 Military Hospital" of the Ministry of Defense of Russia, N. Novgorod1,
SBEE HPE "Nizhny Novgorod State Medical Academy of the Ministry of Health" 2,
FSPE "422 Military Hospital" of the Ministry of Defense of Russia, St. Petersburg3
The Russian Federation

Objectives. To assess effectiveness of sonography in the diagnosis of acute appendicitis.
Methods. The analysis of ultrasound diagnostics effectiveness of acute appendicitis in the multidisciplinary in-patient general surgical military hospital has been performed. Sixty-five patients were enrolled in the analysis, sixty-four younger men, one woman, thirty-four of them were operated on with a confirmed diagnosis of acute appendicitis. In one case, the histological examination verified catarrhal inflammation of the appendix (3%), the rest a destructive acute appendicitis.
Results. The indices of informativeness of this method: sensitivity 79%, specificity 87%, overall accuracy 68%, false negative response 20%, false positive response 13%, positive predicted value 87%. Such characteristics of the appendix ultrasound as noninvasiveness, sufficient informativeness and the ability to perform research in dynamics, lack of radiation exposure to both a patient and staff provide undeniable advantages over the other methods of study. The application of the sonography of appendix in the clinical practice permitted to improve reliably the results of diagnosis and treatment of patients without any invasion as well as to reduce the incidence of unreasonable appendectomies.
Conclusion. Sonography of the appendix is an effective screening method for diagnosing acute appendicitis. High operator dependence can be considered as a disadvantage of this method. Currently, unjustified appendectomy is the most common diagnostic error, determining to a great extent the state and combatant value of patients operated on with acute appendicitis. A necessity to review some principles of specialists training for diversified general surgical hospitals has been appeared. It is expedient for surgeons to complete basic professional retraining with mastering of related specialties, particular ultrasound diagnostics and endoscopy.

Keywords: acute appendicitis, ultrasound diagnostics, endoscopy, unjustified appendectomy, destructive appendicitis, ultrasound examination of the appendix, diagnostic algorithm
p. 160-164 of the original issue
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Address for correspondence:
603105, Rossiyskaya Federatsiya,
g. N. Novgorod, ul. Izhorskaya, d. 25, k. 3,
Nizhegorodskiy voennyiy gospital,
khirurgicheskoe otdelenie,
tel. mob.: 7 (920) 035-06-19,
e-mail: rusdoc77@mail.ru,
Kasimov Rustam Rifkatovich
Information about the authors:
Kasimov R.R. PhD, a surgeon of FSPE "422 military hospital" of the Ministry of Defense of Russia.
Mukhin A.S. MD, professor, a head of the surgery chair of the faculty of advanced training of SBEE HPE "Nizhny Novgorod State Medical Academy of the Ministry of Health".
Elfimov D.A. A surgeon of FSPE "422 military hospital" of the Ministry of Defense of Russia.
Sheleh A.M. A head of the ultrasound diagnostic unit of FSPE "422 military hospital" of the Ministry of Defense of Russia.
Makhnovsky A.I. A chief surgeon of Western Military District of FSPE "422 military hospital" of the Ministry of Defense of Russia (St. Petersburg).
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