25 KB187 KB22 KB192920262003Sedonja, Irenaštevilka:5letnik:72str. 297-300ISSN:1318-0347COBISSID:16252889URN:URN:NBN:SI:doc-FWSTWFDGslSlovensko zdravniško društvoZdravniški vestnikabdomenAbdominal PainApendicitisAppendicitisCecal DiseasesCekalne bolezniCrohn DiseaseCrohnova bolezenDiagnosisdiagnostikaGastrointestinal DiseasesGastrointestinal NeoplasmsGastrointestinalne bolezniGastrointestinalne novotvorbegastrointestinalni traktIleal DiseasesIlealne bolezniNapovedna vrednost testovPredictive Value Of TestsSurgeryTrebušna bolečinaUltrasonografija dopplerska, barvnaUltrasonographyUltrasonography, Doppler, Colorultrazvočna diagnostikaDiagnostična vrednost ultrazvoka v ileocekalni regiji| Value of ultrasound in diagnosis of diseases in ileocecal region|Background. Frequent clinical diagnosis of diseases in ileocecal region is inconclusive and increases with age. Graded compression ultrasonography (US) improves diagnostic accuracy of acute appendicitis but it may be more difficult to carry out in adult patients and other diseases are more frequently in them. The author's own experience in sonography of the ileocecalregion is presented in this study. Methods. 44 patients (15 m., 29 f., 11-76 y., mean 34.4 y.) with acute right lower abdominal pain (37) or withpersistent pain after abdominal surgery (7) in the period from January 2000 to November 2002 were included in this study. Graded compression with convex 3.5 MHz and with linear 7.5 MHz probe on grayscale and Color Doppler sonography was performed. The results of US were correlated with operative findings (all appendicitisses, abscesses, mesenterial pseudocyst and malignancies) or with follow up (other). Results. In 11/12 (91.7%) of patientswith later surgically proved appendicitis, US diagnosed it (6 without /5 with signs of perforation and abscess). In two patients it was false positive, but in one of them operation was justified because of other pathology. In 14/37 (37.8%) of patients with indeterminate right lower abdominal pain, US diagnosed it (10) or proved (4) some other diseases such asCrohn's disease (3) mesentericlymphadenitis(2), infectious ileocecitis (3), ovarian tumour (1), adnexitis (1), myoma in the right part of the uterus (1) and cecal cancer (3). In 10/37 (27%) of patients a disease in ileocecal regionwas excluded. US falsely diagnosed appendicitis in o ne of these patients. In 4/7 of operated patients abscesses were found while in others abdominal wall seroma (1), Crohn's disease (1) and adnexitis (1). Diagnostic value of US in ileocecal region: sensitivity - 0.97, specificity - 0.90. (Abstract truncated at 2000 characters)Izhodišča. Pogosto klinična slika bolezni v ileocekalnem področju ni specifična, posebno pri starejših bolnikih. Ultrazvočna preiskava (UZ) s stopnjevano kompresijo izboljša odkrivanje akutnega apendicitisa, vendar jo jepri starejših bolnikih težje izvesti. Pri odraslih bolnikih so tudi pogostejše druge bolezni v tem področju. Predstavljene so avtoričine izkušnje pri odkrivanju bolezni ileocekalne regije z UZ. Metode. V analizo smo vključili 44 bolnikov(15 m., 29ž. 11761et, povprečno 34, 4 leta) z akutno bolečino v desnem spodnjem kvadrantu trebuha (37) ali z bolečino na tem mestu po operaciji v trebuhu (7), ki so bili v obdobju od 1. jan. 2000 do 10. nov. 2002 z UZ pregledani po enakem protokolu. Pregledali smo jih s konveksno sondo3, 75MHz in z linearno sando 7,5 MHz Uporabili smo tehniko stopnjevane kompresije na sivi skali in barvni dopler. Ultrazvočne izvide smo primerjali sspremembami, najdenimi pri operaciji (vsi apendicitisi, večina abscesov, mezenterialna psevdocista in malignomi), ali z rezultati konzervativnega zdravljenja (drugi). Rezultati. Z UZ je bila pravilno postavljena diagnoza akutnega vnetja slepiča pri 11/12 (91,7%) bolnikov, 6 pred, 5 po perforaciji. Lažno pazitivna sta bila dva izvida, od tega je eden napačno interpretiral drugo patologijo in je bila operacija upravičena. Pri 14/37 (37,8%) bolnikov zneopredeljeno bolečino ileocekalno je bila z UZ ugotovljena (10) ali potrjena(4) druga bolezen - Crohnova bolezen (3), mezenterijski limfadenitis (2), ileocekalni enteritis (3), tumor desnega ovarija (1), adneksitis (1), miomi v desnem delu uterusa (1), rak cekuma (3). Pri 10/37 (27%) bolnikov je bila končna diagnoza negativna. UZ je bil v enem primeru lažno pozitiven v smislu akutnega apendicitisa. Pri operirancih s trajajočo bolečino ileocekalnoje UZ pokazal patologijo pri vseh: absces (4), serom v trebušni steni (1), adneksitis (1), Crohnovo bolezen (1). (Izvleček skrajšan na 2000 znakov)TEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo