A Study of Ultrasonic and Histological Findings of Appendicitis

Tsuyoshi Igami, Akihiro Yamaguchi, Masatoshi Isogai, Akihiro Hori, Yugi Kaneoka, Yoshihito Takahashi, Masahide Ri and Kiyoshi Suzumura

Department of Surgery, Ogaki Municipal Hospital

We treated and performed appendectomies on 9, 295 patients from 1973 to 1995. The ultrasonic findings of appendix from 627 of these patients were classified into the following 5 types: type I, unclear wall contrast and no swelling of the appendix; type II, clear wall contrast and no irregular appendix; type III, clear wall contrast and irregular appendix; type IV, unclear wall contrast and swelling of the appendix; type V, fluid collection in the periappendix. We evaluated the histological findings of appendicitis using these types. The relationship between ultrasonic and histological findings were as follows: type I, normal appendix; type II, catarrhal appendicitis; type III, phlegmonous appendicitis; type IV, gangrenous appendicitis; type V, abscess formation. The findings show that it is possible to make a diagnosis form the histological findings of appendicitis using ultrasonic findings of the appendix. We consider that type II is a relative indication for appendectomy, and that types III, IV, and V are absolute indications for appendectomy.

Key words
acute appendicitis, ultrasonic diagnosis of appendicitis, histological findings of appendicitis, appendectomy

Reprint requests
Tsuyoshi Igami Departmens of Surgery, Ogaki Municipal Hospital 4-86 Minaminokawachou, Ogaki, 503-8502 JAPAN

Accepted
November 13, 1998

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