To diagnose appendicitis, abdominal ultrasound can be used for young people. It is very accurate in detecting acute appendicitis. However, it may not be accurate for obese people. For them, other imaging techniques like CT scans are recommended. Learn about the common pitfalls in detecting it through ultrasound in this article.
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How Does Abdominal Ultrasound Work?
To perform an acute appendicitis ultrasound, the doctor uses a high-frequency transducer that produces high-frequency sound waves to detect organs. The doctor will apply pressure on the transducer over the painful sensitive area to detect acute appendicitis. It investigates and evaluates the swelling of the inflamed appendix. It is highly accurate in detecting appendicitis with a success rate of 98% and also collects valuable information in diagnosing diseases that cause pain in the right iliac fossa.
However, ultrasound diagnosis of acute appendicitis is difficult for an obese patient because their abdomen is distended, and their bladder is overdistended. The same goes with a patient who has been pregnant for more than 6 months as their abdominal wall becomes reactive and the appendix is located abnormally. In those cases, other diagnosis methods are used.
Pitfalls in ultrasound
While ultrasound is a good option for the diagnosis it, in young children and slim adults, it is not very accurate when it comes to obese patients because the abdomen gets distended, and the bladder is overdistended. Also, if the patient is more than 6 months pregnant, the abdominal wall is reactive which makes it difficult to find the appendix.
Additionally, the US (ultrasound) examination can be found false-negative in the case of an inflamed appendix. This happens because an inflamed appendix and other abnormalities cause significant symptoms like ovarian cysts, so it is considered inflamed and not recognized as the appendix. Stats show that an inflamed appendix cannot be unnoticed in the hands of untrained personnel and can result in a non-visualized appendix. Only experienced lab technicians can visualize inflamed appendix in 80 to 90% of patients with acute appendicitis.
Here are the common pitfalls that cause non-visualization and methods to avoid them.
- Retrocecal appendicitis:
The appendix is usually found at maximum tenderness. In retrocecal appendicitis, the cecum is pushed medially with the US probe so that the appendix can appear in the local lateral area of the cecum, not behind it. Another way to visualize the appendix in retrocecal appendicitis is by positioning the probe in the right flank which prevents the gas and feces-filled cecum.
Another way to retrocecal appendicitis is to push the inflamed appendix with the left hand in the direction of the probe. To find the appendix, it may be useful to the ileocecal valve. The base of the appendix is generally found 3 centimeters (about 1.18 in) caudally, where it leaves the cecal pole at the medical side.
If you need help with your abdominal problems, visit our gastroenterology clinic in Brooklyn to get professional medical help. You can schedule an appointment with Doral Health and Wellness Gastroenterology Center’s best gastro doctors in Brooklyn. If you are looking for treatments, you can also talk to our specialists and inquire with them. To schedule an appointment, please visit us at 1797 Pitkin Avenue, Brooklyn, New York 11212 or call 1-347-384-5690.
