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首页> 外文期刊>Journal of Clinical Ultrasound: JCU >Sonography for appendicitis: Nonvisualization of the appendix is an indication for active clinical observation rather than direct referral for computed tomography
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Sonography for appendicitis: Nonvisualization of the appendix is an indication for active clinical observation rather than direct referral for computed tomography

机译：阑尾炎的超声检查：阑尾不可视化是积极进行临床观察的指示，而不是直接推荐进行计算机断层扫描

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Purpose.: To determine the prevalence of perforated and nonperforated appendicitis in patients with nonvisualization of the appendix on ultrasound (US) performed for suspected appendicitis, and to evaluate the value of CT in these patients. Methods.: We analyzed 400 consecutive patients undergoing US for suspected appendicitis. Of these patients, 260 had nonvisualization of the appendix, but otherwise normal scans. We analyzed the clinical outcome in these patients to determine the prevalence of appendicitis, referrals for CT, and the contribution of CT in these patients. Results.: Of the 400 patients, 140 (35%) had either a normal (80 patients, 25%) or an abnormal appendix (60 patients, 15%); 260 (65%) had nonvisualization of the appendix. Overall 75 patients had appendicitis (18.8%) and 17 (4.3%) had appendicitis with perforation. Of the 260 patients with nonvisualization of the appendix, 14 patients (5.4%) had appendicitis and 2 were perforated (0.8%). The prevalence of perforated and nonperforated appendicitis in this group was significantly lower than the overall group (p < 0.001 and p < 0.01, respectively). Of these 260 patients, 101 patients (38.8%) had CT within 48 hours and 79 (78.2%) had normal scans. Conclusions.: Patients with nonvisualization of the appendix on US, but otherwise normal scans, are at significantly lower risk for appendicitis, either perforated or nonperforated. Active clinical observation should be considered in these patients, rather than direct referral for CT.
机译：目的：确定在怀疑阑尾炎的超声（US）检查不可见的患者中，穿孔性和非穿孔性阑尾炎的患病率，并评估这些患者的CT价值。方法：我们分析了连续400例接受US治疗的可疑阑尾炎患者。在这些患者中，有260例看不到阑尾，但其他扫描正常。我们分析了这些患者的临床结局，以确定阑尾炎的患病率，CT的转诊以及这些患者中CT的贡献。结果：在这400例患者中，有140例（35％）的阑尾正常（80例，25％）或阑尾异常（60例，15％）; 260（65％）人的附录没有可视化。共有75例阑尾炎（18.8％）和17例（4.3％）阑尾炎穿孔。在260例阑尾不可视的患者中，14例（5.4％）患有阑尾炎，2例穿孔（0.8％）。该组穿孔性和非穿孔性阑尾炎的患病率显着低于整个组（分别为p <0.001和p <0.01）。在这260名患者中，有101名患者（38.8％）在48小时内进行了CT检查，而79名（78.2％）的扫描结果正常。结论：在美国，阑尾炎不可视，但其他扫描正常的患者，穿孔或不穿孔的阑尾炎风险显着降低。这些患者应考虑积极的临床观察，而不是直接转诊CT。

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