超声对粪石性阑尾炎的诊断价值及其临床意义

Diagnostic value and clinical utility of ultrasonography in the detection of stercoral appendicitis

目的探讨超声对粪石性阑尾炎的诊断价值及其临床意义。方法对经手术病理证实的45例粪石性阑尾炎进行回顾性超声分析。结果本组45例粪石性阑尾炎的超声诊断符合率97.7%(44/45),超声所提示的粪石大小、数目与手术病理一致。45例粪石性阑尾炎中,单纯性阑尾炎5例,化脓性阑尾炎28例,坏疽性阑尾炎9例,慢性阑尾炎急性发作3例。其中一例粪石性阑尾炎同时合并回盲部肿瘤。结论超声可以作为粪石性阑尾炎的术前诊断依据,能明确阑尾炎是否伴粪石形成,以及粪石的大小,数目,具有很高的超声诊断价值及临床应用价值。

Objective To evaluate the diagnostic value and clinical utility of ultrasonography in the detection of stercoral appendicitis before operation. Methods The sonograms of 45 patients with stercoral appendicitis were reviewed retrospectively and compared with surgical/ pathologic findings. Results The accordance rate of ultrasonography in the diagnosis of 45 cases of stercoral appendicitis was 97.7%（44/45）compared with surgical/pathologic findings. The size and number of fecaliths detected by ultrasound were identical with surgical/pathologic findings. According to pathology, 45 cases ofstercoral appendicitis were classicified into four principal categories： simple appendicitis in 5 cases, purulent appendicitis in 28 cases, gangrenous appendicitis in 9 cases and chronic appendicitis in 3 cases. One case of stercoral appendicitis was complicated by ileocecal junction tumor, which was missed on ultrasonography. Conclusion Ultrasonography shows the number and size of fecaliths in stercoral appendicitis. Therefore, the diagnosis ofstercoral appendicitis with ultrasonography is of clinical importance preoperatively.