Ultrasound diagnosis of appendicitis. Diagnosis of appendicitis with ultrasound What ultrasound is done to determine appendicitis

Pain in the abdomen can be of a completely innocent nature, associated with overeating or minor ailments, but sometimes they are signs of a more formidable and insidious disease -. In this case, it is very important to see a doctor as soon as possible, because appendicitis threatens with very serious and dangerous consequences for the body, up to death, if the case is brought to a rupture of the appendix.

A visit to a doctor who will refer the patient for an ultrasound diagnosis will make it possible to catch the disease at the earliest stages. In the vast majority of cases, this ensures the fastest possible recovery without consequences.

Appendicitis is an acute inflammation of the appendix of the caecum, which is also called the appendix. Although the process belongs to rudimentary organs, it continues to perform three main useful functions, accumulating and growing colonies of beneficial intestinal microflora in itself, producing some, and also acting as a barrier to various infections.

But, despite the fact that some doctors insist on the benefits of this organ, which was previously considered absolutely useless or even harmful, in case of inflammation, it has to be quickly parted with by surgical intervention. The best way to determine appendicitis, even in the absence of a vivid clinical picture, becomes.

A doctor may prescribe an examination of organs in the following cases:

• The patient complains of pain of varying intensity, which can be concentrated in different parts of the abdomen. Most often, appendicitis is indicated by pain in the right iliac region or the right side of the lower abdomen.
• The doctor has preliminary data of anamnesis and examination, allowing to suspect the presence of appendicitis.
• shows the shift of the formula to the left as .
• It is necessary to exclude the possibility of the presence of inflammation of the process of the caecum with blurred, non-specific symptoms.

Ultrasound for appendicitis is also used in atypical cases, especially in children, the elderly, pregnant women and patients weakened by other diseases. They may feel pain in a place other than where it usually occurs when they have appendicitis.

Ultrasound examination can put an end to doubts about the nature of pain in people with an abnormal location of the appendix.

The fact is that this rudimentary organ in different people can be located differently, not in the way we are used to seeing on anatomical manuals. This is a movable segment of the caecum, which can change its direction in. Depending on this, the pain may be felt in a different way and not where it occurs in classic cases of appendicitis. In such a situation, two methods are usually used: (CT) and ultrasound (ultrasound). The latter option is used more often due to its lower cost, availability and speed (not all hospitals are equipped with CT units, but appendicitis is found everywhere).

Preparation and conduct of the procedure

Special preparation for ultrasound with appendicitis is not required, especially since very often this procedure is performed urgently, according to vital indications. When a patient is brought to the hospital with an acute picture of appendicitis, the diagnosis can be confirmed as quickly as possible only with the help of.

During a routine examination, it is advisable for the patient to refrain from overeating, eating food that causes flatulence, and also to come to the procedure with an empty stomach.

The study is performed in the same way as an ultrasound of any other abdominal organs.

In the vast majority of cases, a conventional abdominal sensor is used for it, with the help of which diagnostics are performed through the abdominal wall. To enhance contact and better conductivity, a special gel is used, so the patient needs to have a diaper with him to lay under himself, and a towel (napkin) to wipe off the gel after the procedure.

In rare cases, in women with an abnormally low and deviated position of the appendix, a study is used with the help. It allows you to exclude other diseases and conditions, such as ectopic pregnancy, adnexitis or ovarian apoplexy.

Detection of appendicitis is possible by different diagnostic methods. In cases where the symptoms are mild, the disease is latent, the inflammatory process can be determined using an ultrasound examination. The reliability of diagnosis is over 90% and allows you to detect the presence of problems associated with other organs of the patient. Is it possible to see appendicitis on ultrasound, the advantages and disadvantages of diagnosis, the features of the procedure in women and children, are discussed in the article.

Manifestations of inflammation of the appendix in most cases has severe symptoms. The general picture of the patient's condition, complaints of soreness and the location of the focus of pain clearly indicate the diagnosis. The development of the disease proceeds rapidly, the attack turns into complications in the form of peritonitis, sepsis, gangrene. These options require urgent care and surgical intervention. But there is a sluggish course of inflammation, in which the patient does not notice the usual symptoms. These cases make wave diagnostics an indispensable research method.

Signs similar to acute appendicitis occur when other organs of the abdominal cavity become inflamed. It is important to differentiate the conditions to determine the true diagnosis of the patient. Often the situation is complicated by the atypical location of the process of the caecum in the abdominal cavity. With an atypical location, it is difficult to determine the location of the focus of pain. In these cases, ultrasound of appendicitis determines the correct diagnosis and allows you to prescribe an adequate course of treatment.

Advantages:

• Security. Unlike diagnostics using X-ray irradiation, diagnosing using an apparatus with an ultrasonic sensor does not pose a health hazard. This is especially true when examining pregnant women and children.
• Availability. Many experts are inclined to believe that CT has the most reliable diagnosis. However, the results of the ultrasound examination are no less accurate, but at the same time more accessible and cheaper.
• Speed. In an emergency, you need to save as much time as possible. The procedure does not require additional preparation before the procedure. Ultrasound shows the patient's condition in real time.

The relevance of the use of ultrasound in diagnosis is high for patients of childhood and for women in pregnancy. Children, due to age and lack of experience, cannot describe the exact picture of pain and the location of uncomfortable sensations. Pregnant women are at risk due to the displacement of the appendix into an atypical position by the increased volume of the uterus. Both cases involve the study of ultrasound waves, which in these cases is called the most accurate way of diagnosis.

With all the advantages, there are a number of disadvantages. According to ultrasound, it is impossible to consider the focus of inflammation in the presence of excess weight in the patient. A large accumulation of gases in the intestines also makes it difficult to diagnose due to the inability to examine the problem area.

What does ultrasound show

Ultrasound does not involve preparation. The procedure is carried out using a special sensor through the wall of the peritoneum. Sometimes women undergo a vaginal examination with an atypical location of the organ or with gynecological problems in the form of an inflammatory process in the ovaries.

During the study, the doctor discovers the caecum, from which the appendix branches off, even if it is in an atypical location. When examining the appendix, the doctor can detect the presence of an inflammatory process in the process of the caecum and neighboring vital organs. A number of factors indicate the inflammatory process of the appendix:

• Irregularity in the thickness of the walls of the body.
• Size increase.
• The presence of fluid in the branch of the caecum.
• Inflammation of the omentum.
• Abscesses of the peritoneum.
• Layered and discontinuous structure of the appendix.

Diagnosis by ultrasound is prescribed in the presence of constant aching pains, non-specific for inflammation of the appendix. For the differentiation of acute appendicitis from diseases of other organs of the patient, especially from gynecological problems, this study is indispensable. Especially reliably it shows atypical symptoms in chronic inflammation.

Carrying out the procedure

With a weak severity of pain, with an atypical location of the painful area, the analysis is carried out in the following way:

• Examination of the apex of the caecum.
• Iliac vessels detection.
• Study of the iliac muscle.
• Study of the place behind the caecum.
• Analysis of the state of the organs of the peritoneum and small pelvis.
• Especially for women, an examination of the right ovary is performed.

The doctor makes the final diagnosis. There is not always enough data to make an adequate diagnosis. Some cases involve additional tests, diagnosis using MRI, laparoscopy or CT. Conclusions are made on the basis of the results of all types of studies.

Often, ultrasound is prescribed after removal of the appendix, especially if complications occur or a sharp deterioration in the patient's condition, allowing you to see the internal source of the complication.

Carrying out in women

The female body is arranged a little differently. Therefore, the appearance of pain characteristic of appendicitis may indicate gynecological problems in the form of inflammation of the appendages or an ectopic pregnancy. Therefore, the doctor cannot make a correct diagnosis only on the basis of probing the peritoneum and the results of blood and urine tests. This is exactly the option where ultrasound is indispensable.

During the procedure, a clear source of pain is visible. Examination of the organs of the peritoneum and small pelvis displays the condition of the appendages and appendix, allowing you to diagnose the exact cause of the ailment. The procedure for examining female patients is carried out more often due to the structural features of the female body. The internal sexual structure of women, the organs of the urinary system are in close contact with the digestive. As a result, inflammatory processes in the gynecological parts of the woman's body pass to the genitourinary system or intestines.

In addition, during menstruation, the woman's uterus swells, increases in volume and displaces the rest of the organs in the abdominal cavity. During pregnancy, the uterus increases many times, in addition to displacement, it compresses and disrupts blood circulation in the gastrointestinal tract, which leads to inflammatory processes. In this case, ultrasound remains a relevant research method that can show an accurate picture.

Features of the procedure in childhood

Children are not always able to describe the symptoms of an attack, they cannot indicate where the pain is located. Conducting an ultrasound examination in children is a safe and fast way to establish the cause of pain and an accurate diagnosis. The attack itself develops in a child much faster than in adults.

This is due to the physiology of the structure of the child, the course of metabolic processes. A provocateur of an attack can be ARVI or tonsillitis, malnutrition, dysbacteriosis, gastritis. Ultrasound will show the focus of inflammation and the cause of its development.

In some cases, removal surgery is contraindicated, antibiotic therapy is prescribed. Gradually, appendicitis becomes chronic. The described moment involves a mandatory ultrasound examination two or three times a year to monitor the condition of the appendix. This is necessary because the disease in a chronic condition can proceed secretly and lead to aggravating consequences for human health.

Ultrasound diagnostics is an informative, safe, affordable method for detecting pathology in acute appendicitis. The procedure will help the doctor to differentiate the malaise from other diseases, to see the inflamed processes, to exclude or determine the presence of problems in neighboring abdominal organs. Diagnosis can make it possible to establish the correct diagnosis, and if there is insufficient data, it is supplemented by laboratory tests, MRI or CT.

It is important to take care of your health, monitor your physical shape and well-being, seek help in case of ailments in time. Strong immunity will allow you to maintain health, prevent the development of pathological conditions and complications, and ensure a speedy recovery from diseases. Well, if the body failed, and medical assistance was required, modern research methods in the form of diagnosing using ultrasound will help to make an accurate diagnosis, to identify the true cause of the disease.

Appendicitis is an inflammation of the appendix (appendix). The gut itself is a kind of "tube" that ends blindly and in our body is part of the immune system.

The ultrasound method is currently an integral part of the diagnosis of many diseases, but these are, as a rule, parenchymal organs or vessels. From which the question arises: “does ultrasound show appendicitis?”. First you need to understand that appendicitis proceeds quite differently.

• If half will have classic symptoms that allow a quick preliminary diagnosis, then in others they may be distorted.
• In addition, the appendix may have different positions in, which makes diagnosis and treatment difficult.
• Sometimes the symptoms characteristic of appendicitis hide the disease of other organs, such as diverticulitis.

As a result, the question of whether it is possible to see appendicitis on ultrasound remains open in some cases. In most cases, a clinic, an objective examination by a surgeon and blood tests are sufficient to establish an intraoperative diagnosis.

However, as mentioned above, there are also atypical cases of the course. In addition, some patients should also perform an ultrasound examination before surgery. These include the elderly, children and pregnant women. It is worth highlighting separately. This is due to the fairly frequent need for differential diagnosis with ectopic or inflammation and.

What are the cases and advantages in order to do an ultrasound for appendicitis

Preference is given to the ultrasound method of examination for a number of important reasons.

• Appendicitis is an acute process that requires rapid diagnosis, delay can lead to a rupture of the appendix, due to which the patient will develop peritonitis.
• The method of ultrasound of the appendix is ​​the fastest. The duration of the examination takes 15-30 minutes.
• The next factor is harmlessness. Ultrasonic waves do not carry any harm, which means they can be safely used to diagnose appendicitis in children of any age and pregnant women.

Ultrasound for appendicitis is a painless procedure and does not require breaking the skin, which is a plus when performing it in children.

As a differential diagnosis, ultrasound has an undeniable advantage, allowing you to immediately detect lesions, ovaries, etc. And besides all of the above, ultrasound is one of the most accessible and mobile methods of examination.

And again returning to the question of whether it is possible to see appendicitis on ultrasound, it is necessary to answer that in 90% of cases, ultrasound diagnosis of the appendix provides an accurate picture of the disease. Much depends on the specialist who conducts the examination, the conditions, the state of the body and the modernity of the ultrasound machine.

When ultrasound of the appendix, as a method, was not possible or not widely used, the method of contrast radiography with a barium passage was used. With such a study, serious restrictions were imposed on the circle of patients who underwent such an examination. In addition, it had much less information content than ultrasound.

How is it done, preparation and what does an ultrasound of the appendix show

Any preparation before performing an ultrasound for appendicitis is not required. Examination can be performed even immediately upon admission. The operation of the ultrasound machine consists in the emission of different-frequency ultrasonic waves, which, hitting the tissue, return and are recorded by the sensor. After, the received signals are transformed into an image, and the doctor determines whether the appendicitis is visible on the ultrasound. Usually, the examination is performed through the abdominal wall, but women can also perform.

The method used
received by diagnosticians - dosed compression. Its use in ultrasound of the appendix is ​​justified by the need to remove air from the intestines, because. it greatly distorts the results of the study. Before starting, the patient is laid on his back and the area of ​​study is lubricated with gel. Ultrasound is accompanied by vibrating pressures carried out by the doctor. During an ultrasound examination of appendicitis, the doctor evaluates:

• wall condition,
• appendix size,
• surrounding tissues.

You can identify appendicitis by some signs:

• wall thickening (more than 3 mm),
• a general increase in the diameter of the appendix (more than 7 mm),
• pathology in the surrounding adipose tissue.

A severe complication that can develop with appendicitis is perforation (rupture). In this case, the patient rapidly develops peritonitis. You can determine the perforation by:

• abscesses in the abdominal cavity;
• inflammation of the omentum;
• the presence of fluid in the abdominal cavity;
• discontinuous contour of the wall of the appendix.

In the absence of the appendix in a typical place, a complete revision is carried out, because it can be in many places, including in the area or liver. When the process is found and not inflamed, other diseases that can lead to a similar clinical picture must be excluded. In this case, the patient may need to perform simple functional tests or change position during the ultrasound examination of the appendix.

If an ultrasound of the appendix is ​​performed by a pregnant woman, then you need to remember about the displacement of the appendix somewhat upward. An obstacle in an adequate assessment of the state and some distortion can contribute to developed fatty tissue and excessive accumulation of gases in.

If a patient is suspected of having acute appendicitis, a diagnosis cannot be made solely on the basis of ultrasound. The surgeon must take into account the general condition of the patient, the data that he received during the examination and examination.

Although ultrasound is done during the examination of appendicitis, this imaging method is not recognized by all doctors. Do not forget that appendicitis is one of the acute diseases that often require urgent surgical intervention, since it is impossible to cure it with a conservative method.

Appendicitis can be detected by various examination methods. Sometimes there are situations when the inflammation is secretive, or the main symptoms are mild. In these cases, an ultrasound of the appendix is ​​performed to exclude other diseases with similar symptoms. The accuracy of ultrasound examination reaches 90%!

Benefits of ultrasound diagnosis of the appendix

With dangerous complications of appendicitis, such as sepsis, perforation, gangrenization, urgent surgical intervention is necessary. With pronounced symptoms, doctors rely on the overall clinical picture. But if the symptoms are not so pronounced, or the appendicitis itself proceeds atypically, then delay in surgical intervention can cost the patient's life. In these cases, resort to ultrasound examination of the appendix.

The procedure allows you to determine the current state of the patient. Moreover, almost half of abdominal diseases have symptoms similar to acute appendicitis. Interestingly, the very location of the appendix is ​​often completely different, which significantly affects the nature of pain and the course of inflammation. Ultrasound helps to make an accurate diagnosis and prescribe the correct and timely treatment.

Even before the 1980s, barium X-ray radiation was used to examine the appendix. Ultrasound is much safer, especially for pregnant women and children. Many experts single out computed tomography as the most accurate research method. Ultrasound examination is in no way inferior to it, but it is much cheaper and more accessible. In emergency situations, they resort to ultrasound, due to the faster obtaining of data on the patient's condition.

Especially convenient is the use of ultrasound in diagnosing inflammation of the appendix in children and pregnant women. Due to the anatomical features, diagnosing appendicitis with classical research methods is quite difficult. In addition, children themselves often cannot explain in a coherent and accessible way exactly where it hurts them. This makes it difficult to diagnose and prescribe appropriate treatment.

However, there are also disadvantages to this survey method. For example, due to bloating, due to improper preparation for ultrasound, or overweight of the patient, the examination may not show some parts of the abdominal cavity on the monitor screen. In any case, the surgeon makes the final diagnosis and prescribes treatment, while ultrasound is just a way to collect data.

What does the study show?

This procedure does not require special preparation. The study is carried out through the abdominal wall with a special abdominal sensor. In rare cases, women have a retrocecal position of the appendix or pathology of the appendages, in these cases, the study is carried out with another sensor - vaginally.

Regardless of the anomalies in the structure and location, the appendix always begins with the caecum, i.e. grows from its end, so finding the appendix is ​​carried out as follows: find the end of the caecum and the psoas major muscle with the external iliac artery.

During the study, the specialist presses the sensor on the area of ​​\u200b\u200bthe appendix. This leads to some displacement of the intestinal loops and the removal of gas from them. This method improves the visualization of the organ and is called dosed compression. And the echogenicity of the adipose tissue of the appendix can be determined using the duplex scanning method.

Inflammation in the appendix is ​​indicated by:

• thickening of the walls of the process by more than 3 mm, their unevenness;
• its increase in diameter by more than 7 mm;
• the presence of fluid in the organ itself;
• layered and intermittent structure of the appendix;
• increased vascular density and echogenicity of fatty tissue;
• inflammation of the omentum;
• abdominal abscesses.

Most often, ultrasound is prescribed for prolonged pain, without pronounced symptoms of appendicitis. The fact is that other diseases have similar symptoms, especially in gynecology, and this study allows not only to examine the appendix, but also nearby organs. Ultrasound studies have shown themselves especially well in diagnosing chronic appendicitis and its subsequent treatment.

How is the diagnosis carried out?

If the pain is mild, there is difficulty in its localization, then an ultrasound examination of the abdomen is carried out according to the following scheme:

• examination of the tops of the caecum;
• finding the iliac vessels located above;
• examination of the iliac muscle;
• examination of the area behind the terminal ileum and the space behind the caecum;
• general examination and ultrasound of the small pelvis;
• in women, the Douglass space and the region of the right ovary are additionally examined.

It should be noted that ultrasound is not a final study. If the signs of appendicitis are "suspicious", additional laboratory tests are prescribed, for example, a complete blood count, magnetic resonance imaging (MRI), laparoscopy, computed tomography (CT).

The final diagnosis is made by the attending physician based on the data of all examinations. Ultrasound of the appendix is ​​also performed after the operation, especially if the patient's condition has deteriorated sharply, pain has appeared. In this case, antibiotics are prescribed.

Features of diagnosis in women

Due to the peculiarities of the physiological structure in women, the pain characteristic of appendicitis can be caused by an ectopic pregnancy, inflammation of the appendages or the right ovary. As a result, it is very difficult to make a correct diagnosis and prescribe an effective treatment regimen based only on laboratory tests and palpation data. This is where ultrasound of the abdominal cavity and small pelvis comes to the rescue. The specialist is able to reliably determine whether the source of pain is inflammation of the appendix or a gynecological disease. In addition, radiography and other studies may be prescribed.

It is statistically revealed that women are more prone to inflammation of the appendix than men. This is due to the physiological structure.

Firstly, the female organs of the genitourinary system are almost in contact with the organs of the gastrointestinal tract. So inflammation in the genitals is transmitted to the bladder, urethra and even the intestines.

Secondly, during menstruation, blood circulation increases, the uterus "swells", shifts other organs and puts pressure on the appendix. Therefore, complex therapy is possible. Expectant mothers are especially at risk. The growing uterus compresses other internal organs, disrupting normal blood circulation.

Features of diagnosis in pregnant women

Most of the pain that occurs in the abdomen, pregnant women attribute to their "interesting position". This is usually the case, so the symptoms of appendicitis are not immediately recognized. Moreover, in late pregnancy, the appendix itself shifts upward, i.e. its location changes, just affecting the general symptoms of appendicitis and the nature of pain. At the same time, an “acute abdomen” is also associated with other diseases that can also be dangerous for the fetus and the life of a woman. In this case, the diagnosis of appendicitis is necessarily carried out using ultrasound.

The causes of inflammation of the appendix in pregnant women are not fully understood. According to one version, the growing uterus presses on other organs, shifting them. As a result, there is a blockage of the lumen between the appendix and the intestine, which disrupts blood circulation, leading to inflammation. It turns out that pregnancy itself, often, provokes appendicitis. According to statistics among women, acute appendicitis is diagnosed more often in pregnant women.

The main signs of appendicitis in pregnant women:

• pain in the upper abdomen or navel, gradually moving to the lower right region;
• diarrhea, nausea, vomiting;
• heat;
• lack of appetite;
• pallor of the skin;
• sweating.

Sometimes pregnant women notice pain not only over the uterus, but also throughout the abdomen, as well as increased pain in the supine position on the right side. With a low location of the process, the pain radiates to the legs, while the nature of such pains varies greatly, therefore, an ultrasound examination is necessarily indicated.

Appendicitis is dangerous not only for a woman's health. Of the threats, one can distinguish: termination of pregnancy at a later date, infection of the fetus, inflammation of the pelvic organs, intestinal obstruction, premature detachment of the placenta.

At the same time, the threat remains in the postoperative period. Antibiotics are indicated, expectant mothers are prescribed general tonic and sedatives, tk. all experiences are transferred to the baby.

Features of diagnosis in children

Young children often cannot describe the nature and intensity of pain. They cry, act up, pull their legs up to their stomachs. All this complicates the diagnosis. Most often, children of school age are affected by this disease.

As a result, there is swelling of the mucosa of the process, increased tension of its walls, reproduction of pathogenic flora, venous congestion, and impaired arterial circulation. The inflammation itself in children is much more acute and faster than in adults. Appendicitis in children is provoked even by SARS, tonsillitis, otitis, measles, sinusitis, dysbacteriosis, gastritis, constipation and overeating. This is due to the special intestinal microflora and the untimely start of therapy. Some serious illnesses, such as typhoid fever, can cause inflammation of the appendix on their own. Treatment of appendicitis in children occurs only in an operable way.

Sometimes resection of the appendix is ​​contraindicated for various clinical indications. Such cases are less common, but they do occur. As a result, appendicitis is treated with antibiotics, without surgery. It will not be possible to completely cure the appendix, and appendicitis becomes chronic. In the period of exacerbation, treatment in a hospital under the watchful supervision of doctors is indicated. In this case, the ultrasound of the appendix allows you to see the entire clinic of inflammation, track changes. As a consequence, people with chronic appendicitis must undergo examinations 2-3 times a year, incl. ultrasonic, because inflammation can proceed secretly without pronounced pain.

Appendicitis is a common disease of the abdominal cavity. It occurs at any age and requires immediate surgical intervention. The main symptom is a constant aching pain that occurs in the epigastric region, and then covers the entire abdomen. After a while, it is felt in the right iliac region. In some cases, vomiting or diarrhea is observed. To make a diagnosis, an ultrasound of the appendix is ​​performed.

What is appendicitis?

In humans, the intestines are made up of the small intestine and the large intestine. Between them is the caecum. It has a vermiform appendix. Doctors call it the appendix. It is a tubular formation.

Diagnostic methods

Computed tomography (CT) may be done to check for inflammation. This research method allows you to detect appendicitis with a high probability. However, CT has several disadvantages. The following negative aspects can be distinguished:

• the presence of ionizing radiation, which adversely affects the body;
• the use of contrast agents (intravenous or rectal), which sometimes lead to serious complications;
• high cost of research.

Computed tomography can be performed if there is a suspicion of a penetrating defect (hole) in the appendix or an abscess. For pregnant women and children, it is generally undesirable. For the diagnosis of appendicitis, a more suitable method is magnetic resonance imaging (MRI). It has the same high accuracy as CT. Its other advantage is the absence of ionizing radiation. However, computed tomography is extremely rare. It has a higher cost.

CT scanner

Ultrasound diagnostics is the preferred research method. It does not have ionizing radiation, therefore it is absolutely safe for children and pregnant women. The following advantages of this research method can also be distinguished:

• low cost;
• non-invasiveness;
• speed of obtaining results;
• the possibility of repeat research.

The main disadvantage is low sensitivity in the diagnosis of acute appendicitis.

Ultrasound: can a specialist see appendicitis?

There is no consensus on the effectiveness of ultrasound diagnostics in detecting inflammation of the appendix. Some doctors recommend using ultrasound in unclear cases and not prescribing to patients who have a clear clinical picture of appendicitis. It is generally accepted that this research method has a low percentage of visualization of the normal appendix. Patients with obvious symptoms are best to immediately undergo immediate surgical treatment, since an ultrasound specialist may not see appendicitis at all.

Other doctors believe that ultrasound can be performed on all patients without exception (and if appendicitis is suspected, and if there are obvious symptoms). The accuracy of the diagnosis depends on the specialist conducting the ultrasound. A person with more experience is able to notice the echo signs of inflammation. A lot depends on technology. Modern high-resolution ultrasound scanners can detect appendicitis.

Ultrasound

First, a sonologist (radiologist) performs a screening abdominal ultrasound. It gives an overview of the pelvic organs. Such a diagnosis is necessary in order to exclude the presence of other pathologies (for example, acute cholecystitis). After it is carried out, the specialist proceeds to the study of the appendix.

Ultrasound of the appendix is ​​performed by a high-frequency probe. First of all, a search is made for the appendix. Then signs of inflammation are detected in the detected appendix. Experts evaluate:

• the width of the appendix;
• wall thickness;
• the quantity and nature of the contents of the appendix;
• condition of surrounding tissues.

Ultrasound diagnostics takes from several minutes to half an hour. The duration of the examination will be quite short if the sonologist or radiologist can quickly find the appendix. If there are difficulties in visualization, ultrasound is delayed.

Ultrasound signs of inflammation

If the ultrasound shows the expansion of the appendix, then this means that it is covered by the inflammatory process. This is the main symptom of appendicitis. The measurement is done with a transverse scan. The appendix is ​​considered to be dilated when its outer anteroposterior size under compression is greater than 6 mm. If the diameter is less than this value, then acute appendicitis is excluded.

The contents of the lumen of the appendix are also evaluated. Normally it is filled with gas. In the pathological process, only hypoechoic fluid (pus) is visible in the appendix. Rarely, in the inflamed appendix, there is gas secreted by microorganisms. An appendix with such contents causes diagnostic difficulties.

Ultrasound diagnosis also includes measuring the wall thickness of the appendix. As a rule, during the inflammatory process, the value increases. The wall becomes thickened (more than 2 mm). However, it is quite difficult to measure it. Often, the inflamed wall cannot be distinguished from the hypoechoic fluid that filled the lumen of the appendix.

The appendix must be checked for compressibility. During the study, compression is applied. The normal appendix is ​​displaced and changes shape. When inflamed, it does not lend itself to compression. There is no peristalsis.

A fecal stone can be found in the lumen of the appendix. Its size is most often about 1 cm. The fecal stone looks like an echogenic or hyperechoic focus with an acoustic shadow. Its detection indicates an inflammatory process.

The above ultrasonic signs are the main ones. There are additional criteria for appendicitis:

• swollen lymph nodes in the lower right quadrant;
• the presence of fluid around the appendix (it is detected not only with perforation of the process, but also with other pathologies);
• inflammation and an increase in the amount of adipose tissue surrounding the appendix (it becomes more echogenic).

Ultrasound results

If the appendix is ​​visualized with signs of inflammation, then this result is considered positive. Diagnosed with acute appendicitis. The result is negative in cases where the appendix is ​​not detected during the study, and signs of inflammation in the lower right square are not detected.

The appendix can also be visualized without signs of inflammation. This is a true negative result. If the appendix is ​​found, but the criteria for inflammation are inconclusive or insufficient, then the result is considered doubtful.

Ultrasound diagnosis is a simple and quick way to detect appendicitis. This method is successfully used in diagnostic practice, despite the low percentage of visualization of a normal appendix. If the result is positive, immediate surgical treatment is carried out, and if it is doubtful, additional studies (for example, computed or magnetic resonance imaging) are prescribed.