Aveline B, Guimaraes R, Bely N, Salles J P, Cugnenc P H, Frija G
Service de Radiologie, Hôpital Laënnec, Paris, France.
AJR Am J Roentgenol. 1993 Jul;161(1):71-3. doi: 10.2214/ajr.161.1.8517324.
The significance of sonographic findings 1 week or less after appendectomy is difficult to evaluate without knowing the inconsequential abnormalities that may occur in these patients. Accordingly, we performed postoperative sonography on patients who had a normal course after appendectomy to determine the findings that can be considered normal within 1 week after surgery.
Forty-four patients who had an appendectomy for acute appendicitis and who had normal findings at clinical follow-up 5 days and 6 months later were included in the study. In all patients, sonograms were obtained on the fifth postoperative day and interpreted by a radiologist who did not know the surgical findings.
Ten fluid collections (23%) were found in the pericecal area, ranging in size from 10 x 10 mm to 40 x 20 mm. The collections were hypoechoic or anechoic, crescent-shaped, and immobile. Fluid collections were more common in cases of suppurative appendixes (6/20, 30%) than in cases of inflamed appendixes (4/19, 21%) and in retrocecal appendixes (3/9, 33%) than in normally located appendixes (7/34, 21%). However, the differences were not statistically significant (p > .05).
Inconsequential fluid collections are detected with considerable frequency on postoperative sonograms 5 days after an appendectomy. Consequently, not every fluid collection should be considered an abscess.
若不了解阑尾切除术后可能出现的无关紧要的异常情况，就难以评估术后1周及以内超声检查结果的意义。因此，我们对阑尾切除术后病程正常的患者进行了术后超声检查，以确定术后1周内可视为正常的检查结果。
本研究纳入了44例因急性阑尾炎接受阑尾切除术且在术后5天和6个月临床随访结果正常的患者。对所有患者在术后第5天进行超声检查，并由一位不了解手术结果的放射科医生进行解读。
在盲肠周围区域发现10个液性暗区（23%），大小从10×10毫米至40×20毫米不等。这些液性暗区呈低回声或无回声，新月形，且不活动。液性暗区在化脓性阑尾炎病例中（6/20，30%）比在炎症性阑尾炎病例中（4/19，21%）更常见，在盲肠后位阑尾病例中（3/9，33%）比在正常位置阑尾病例中（7/34，21%）更常见。然而，差异无统计学意义（p>.05）。
阑尾切除术后5天的术后超声检查中经常能检测到无关紧要的液性暗区。因此，并非每个液性暗区都应被视为脓肿。
