Mild Pelvicalyceal System Dilatation Observed by Ultrasound as a Sign of Acute Appendicitis
Keywords:
Acute appendicitis, Pelvicalyceal system, Retrocecal, PelvicAbstract
Background and Objectives: The positive pelvicalyceal changes observed by ultrasound in suspected acute appendicitis cases confuse the mind in taking a decision for surgical interferences or medical management. This study aims to analyze the effect of pelvicalyceal system dilatation on the diagnosis of acute appendicitis and the associated factors of mild pelvicalyceal system dilatation in acute appendicitis.
Methods: The study assessed 326 suspected acute appendicitis in addition to 260 cases of functional dyspepsia as a control group. Ultrasound of the abdomen was a principal imaging study in the research with the emphasis on pelvicalyceal dilatation, combined in some cases with KUB, CT and Doppler-Ultrasonography.
Results: Out of 326 cases of acute appendicitis, ultrasound revealed that 34% had RPCSD and 7% had bilateral BPCSD. The pelvicalyceal dilatations were observed in 54.5% of the acute recurrent cases or chronic appendicitis and suppurative appendicitis were 30%. The recorded length of appendix ranged from 3.8 to 18 cm. The position of appendix were mainly pelvic (59%) followed by retrocecal (36.4%).
Conclusions : The Pelvicalyceal system dilatation observed by ultrasound in the suspicious acute appendicitis patients can be served as a sign for diagnosis of acute appendicitis in states of hesitation.
Metrics
References
Alan S, James L. Alimentary tract, appendix. In paul R.Wheater, H george Burkitt Histology, 2nd edition. Hong Kong, lyntone house. 1993; pp 172-176.
Gerst SR, Hedvig H. Radiology of the urinary tract in: Tanagho EA, McAninch JW. Smthi's general urology. 2008: 7th edition. Ch (6) 71-78. McGraw-Hill Companies, Inc. New York.
Michael H. An approach to the 'acute abdomen' in pathways in surgical management, 1989 .ch 24:p 280- 294;:Edward Arnold (publisher) ltd. London.
Harold E. Abdomen and the pelvis; Vermiform appendix. A revision and applied anatomy for clinical students;10th edition; 2001: chapter 2 p80-85.Blackwell Scientific Publication. London
Guidry SP, Poole GV. The anatomy of appendicitis. Am Surg. Jan 1994; 60 (1):68- 71.
Luigi S, Ochoa JB, Tommaso L, Hines J, Talavera F, Grosso MA.. e- Medicine.General surgey. Abdomen.appendicitis; 2006.
Asif S. Gastrointestinal tract and abdominal cavity. In :MCQS in clinical imaging.ch4:pp 116-140. 1994: Champan and Hall medical, 2-6 boundary row, London.
Christopher F. The kidneys and ureters In: Williams NS, Bulstrode CJK, O'Connel PR. Bailey & Loves short practice of surgery.25th edition, Ch 71: 1285-1313: 2008; Hoder Arnold. London
Tundidor Bermudez AM, Amado Dieguez JA, Montes de Oca Mastrapa JL.Urological manifestations of acute appendicitis. Arch; Esp Urol 2006;58(3):207-12.
Herscu G, Kong A, Russell D, Tran CL, Varela JE, Cohen A, Stamos MJ. Retrocecal appendix location and perforation at presentation. Am Surg 2006; 72(10):890.
Hale DA, Molloy M, Pearl RH, Schutt DC, Appendicectomy: a contemporary appraisal. Ann Surg 1997; 225(3):252-261.
Gulzar S, Umar S, Dar GM & Rasheed R. Acute appendicitis – importance of
clinical examination in making a confident diagnosis. Pak J Med Sci 2005: 21(2):125-132.
Bergin C. Genitourinary infection In: Mike B. Siroky, Robert A. Edelstein, Robert J. Krane. Manual of urology diagnsis and therapy.second edition.247-269: 1999 Lippincott Williams and Wilkins. A wolters kluer company Phyladilphia, New York12.
Gerber GS, Brendler CB. Evaluation of the urologic patient. In: Patrick C.
Walsh, Alan B. retic, Alan J. wein, Louis R. Kavoussi,.Andrew C. Novick, Alan W. Parten and Crag A. Peter- Campbells Urology.Eighth edition..Ch 3-pp 81-83:2002: Saunders-Elsevier science.the curtis center.Independent square west Philadelphia; Pennsylvania.
Kabalin JN. Surgical anatomy of retroperitoneal organs, kidneys, ureter,bladder. In: Alan B. etik, E. Darcott Vaugan, Alan J, Wein, Louis R. Kavossi, Andrew C. Novick, Alan W. Partin, and Craig A. Peters. Campbells Urology 2002: 8th Edition,V 1, pp 10
Omundsen M, Dennett E. Delay in appendicectomy and associated morbidity: a retrospective review. Anz J Surg 2006; 76(3)153-155.
Steve H,.Robinson PJ. Appendicitis.Large bowel. In:David Sutton.Text book of radiology and Imaging. Volume 1: Section 4:ch21:652-3: 2003; Churchill Livingst one. Elsiver limited.Pheladilphia.
Guidry SP, Poole GV. The anatomy of appendicitis. Am Surg 1994; 60 (1):68- 71.
19.Kim S, Lim HK, Lee JY, Lee J, Kim MJ, Lee AS. Ascending retrocecal appendicitis: clinical and computed tomographic findings. J Comput Assist Tomogr 2006;30 (5): 772-6.
Sinnatamby CS. Abdomen. In: Lasts anatomy regional and applied.10th edition.churchill Livingston. London: 2006: pp249-290.
Jeffrey RB, Manaster BJ, Gurney JW, Zimmerman RD, Cure JK, Donney LF. Diagnostic Imaging Emergency. PartII-section 3: Abdomen/Pelvis pp 76-79: 2007, AIRSAY-Canada
Green R. Urology consultation, urology examination- Urology instistute. stuart george institiute 2002:13244-6748
Teke Z, Kabay B, Erbiş H, Tuncay OL. Appendicolithiasis causing diagnostic dilemma: a rare cause of acute appendicitis. Ulus Travma Acil Cerrahi Derg 2008; 14(4):323-325.
Morishita K., guishimiyagi M.,Hashiguchi M., Stein GH, and Tokuda Y.Clinical prediction rule to distiguish pelvic inflammatory diseases form acute appendicitis in women of child bearing age. American J Emerg Med 2007;25(2):152-7.
Nigar C, Muzaffer IS, Gulsum O. ELPEK: Mast cell density and neuronal hypertrophy in patients with acute appendicitis The Turkish Journal of Gastroenterology, 2003.
Cathy M. Functional obstruction: the renal pelvis rules. J Clin Invest 2004; 113(7): 957–959.
Downloads
Published
How to Cite
Issue
Section
License
The copyright on any article published in Zanco J Med Sci is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).