Johnson J F, Coughlin W F, Stark P
Department of Radiology and Pediatries Children's Hospital Medical Center, Cincinnati, Ohio.
Rofo. 1988 Dec;149(6):619-23. doi: 10.1055/s-2008-1048417.
The plain films of 37 patients under age 18 with surgically and pathologically proven non perforated (16/37) and ruptured (21/37) appendicitis were reviewed in order to determine the ability of the plain film to specify perforation. Perforation was suggested when one or more of the following six findings were clearly defined: 1. Acute small bowel obstruction. 2. Extraluminal gas. 3. Mass in the right lower quadrant. 4. Colon cut-off sign at the hepatic flexure. 5. Fecalith. 6. Obliteration of the pelvic fat planes. This approach resulted in a sensitivity of 80% and a specificity of 94%, with the only false positive for perforation occurring in a patient with a fecalith. In five patients, extraluminal gas produced a triangular accumulation in the right flank which could be distinguished from intraluminal bowel gas on the supine or prone film.
对37例18岁以下经手术和病理证实为非穿孔性（16/37）和穿孔性（21/37）阑尾炎患者的平片进行回顾，以确定平片对明确穿孔的能力。当出现以下六项发现中的一项或多项时提示穿孔：1. 急性小肠梗阻。2. 肠外气体。3. 右下腹肿块。4. 肝曲处结肠截断征。5. 粪石。6. 盆腔脂肪平面消失。这种方法的敏感性为80%，特异性为94%，唯一的穿孔假阳性发生在一名有粪石的患者中。在五名患者中，肠外气体在右侧胁腹部形成三角形积聚，在仰卧位或俯卧位片上可与肠腔内气体区分开来。
