|Title:||Appendiceal outer diameter as an indicator for differentiating appendiceal mucocele from appendicitis||Authors:||WAN-CHING LIEN
|Issue Date:||2006||Journal Volume:||24||Journal Issue:||7||Start page/Pages:||801-805||Source:||American Journal of Emergency Medicine||Abstract:||
Background: Patients with appendiceal mucocele (AM) commonly present with features indicative of acute appendicitis. In emergency departments, accurate preoperative diagnosis is crucial to prompt appropriate treatment. This study investigates the clinical and sonographic characteristics of AM, which may prove useful in preoperatively differentiating AM from appendicitis. Methods: This case-control study compares the clinical and sonographic findings of 16 histologically confirmed AM with sex- and age-matched control subjects (n = 64) with appendicitis by a 1:4 ratio. Conditional logistic regression was applied to estimate the odds ratio (OR) and 95% confidence intervals (CI) of clinical and sonographic parameters associated with AM. Results: Univariate analysis demonstrated that the larger appendiceal outer diameter by sonography was positively correlated with diagnosis of AM (OR, 2.31; 95% CI, 1.42-3.72) and right lower quadrant abdominal pain was negatively correlated (OR, 0.38; 95% CI, 0.17-0.82). However, multiple regression analysis suggested that only outer diameter remained significant (OR, 2.21; 95% CI, 1.36-3.59) after adjusting for age, sex, and right lower quadrant pain. An outer diameter of 15 mm or more was predictive of AM diagnosis, with a sensitivity of 83% and specificity of 92%. Conclusion: When the threshold is set at 15 mm, appendiceal outer diameter by sonography is a useful preoperative measurement for differentiating between AM and acute appendicitis. ? 2006 Elsevier Inc. All rights reserved.
|ISSN:||0735-6757||DOI:||10.1016/j.ajem.2006.04.003||SDG/Keyword:||abdominal pain; acute appendicitis; adult; aged; appendix disease; appendix mucocele; article; case control study; clinical article; clinical feature; comparative study; confidence interval; diagnostic accuracy; diagnostic approach route; diagnostic imaging; female; human; logistic regression analysis; male; multiple regression; peroperative echography; prediction; preoperative evaluation; priority journal; univariate analysis; Adult; Aged; Aged, 80 and over; Appendectomy; Appendicitis; Appendix; Case-Control Studies; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Mucocele; Sensitivity and Specificity
|Appears in Collections:||醫學系|
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