Ultrasonographic diagnosis of acute appendicitis in surgical indication.

The visualization rate and cross section width of the appendix were compared with the severity of appendicitis by using ultrasonography in 77 patients with acute appendicitis. An appendicitis echo was obtained in 100% of phlegmonous and gangrenous appendicitis cases in which emergency surgery was indicated, but in only 32% of catarrhal appendicitis cases in which conservative therapy was generally indicated. The cross section width of the appendix was 19.00 +/- 2.76 mm in gangrenous appendicitis, 15.22 +/- 3.73 mm in phlegmonous appendicitis and 9.50 +/- 1.76 mm in catarrhal appendicitis; i.e. the severer the inflammation the longer the diameter (p less than 0.01). A fluid echo, which suggests the existence of a complication, was observed in patients with gangrenous and phlegmonous appendicitis. The above facts suggest that ultrasonographic examination can be useful in assessing the severity of acute appendicitis.