Puylaert J B
Radiology. 1986 Dec;161(3):691-5. doi: 10.1148/radiology.161.3.3538138.
One hundred seventy consecutive patients with clinical suggestion of acute appendicitis were studied by ultrasound (US) with the examiner using the graded compression technique. In 14 patients, the only US findings consisted of enlarged mesenteric lymph nodes in combination with mural thickening of the terminal ileum. This was consistent with the findings at surgery in four patients and with the results of barium studies in seven patients. In nine of 14 patients, stool cultures were performed, eight of which were positive for Yersinia enterocolitica. None of these 14 patients finally proved to have appendicitis. In a patient with acute pain in the right lower quadrant whose appendix cannot be visualized sonographically and whose US findings consist of enlarged mesenteric lymph nodes and mural thickening of the terminal ileum, the diagnosis is probably mesenteric adenitis and acute terminal ileitis. Appendectomy should be avoided in this condition.
对170例临床提示急性阑尾炎的连续患者进行了超声（US）检查，检查者采用分级压迫技术。在14例患者中，唯一的超声检查结果是肠系膜淋巴结肿大并伴有回肠末端肠壁增厚。这与4例患者的手术结果以及7例患者的钡剂检查结果一致。在这14例患者中的9例进行了粪便培养，其中8例小肠结肠炎耶尔森菌呈阳性。这14例患者最终均未证实患有阑尾炎。对于右下象限急性疼痛且超声检查无法显示阑尾、超声检查结果为肠系膜淋巴结肿大和回肠末端肠壁增厚的患者，诊断可能为肠系膜腺炎和急性回肠末端炎。在这种情况下应避免进行阑尾切除术。
