R.F. MAKHMUTOV, G.A. NOVIKOV

1. Gorky Donetsk State Medical University, Donetsk

Contact details:

Makhmutov R.F, MD, Professor of the Department of Pediatrics No. 2

Address: 16 prospekt Illyicha, 283003 Donetsk, Donetsk People’s Republic, Russian Federation, tel.: +7-856-297-89-01, e-mail: ravilclassic@yandex.com

 Ultrasound examination is often performed in children to diagnose acute appendicitis with varying degrees of effectiveness. Determination of individual or a set of sonographic signs can significantly improve the diagnostic value of the examination. The article presents a review of the Russian and foreign sources in order to determine and analyze the effectiveness of sonographic signs of acute appendicitis, in particular in children of the first 6 years of life. The most reliable sign in visualizing appendicitis is the maximum external diameter of the appendix of more than 6 mm under compression. To reduce the percentage of false-positive results for this criterion in doubtful cases, attention should be paid to the intraluminal contents, the presence of periappendicular changes, the maximum wall thickness, the preservation of wall layers and increased blood flow in the wall of the appendix, and the absence of gas in the lumen. Secondary sonographic signs include pain during compression and the presence of periappendicular echogenic adipose tissue when the appendix is not visualized. Taking into account the primary and secondary sonographic signs, the accuracy of echographic diagnosis of acute appendicitis is 89%, sensitivity is 84.7%, and specificity is 92.1%. For the diagnosis of perforated appendicitis, the greatest diagnostic value is provided by a combination of dilation of intestinal loops and the presence of echogenic fat and fluid in the right lower quadrant.

Key words: acute appendicitis, ultrasound, diagnosis, children.

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