Çocuklarda akut apandisit tanısında spiral bilgisayarlı tomografinin yeri

---

Thesis Type: Expertise In Medicine

Institution Of The Thesis: Ankara University, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Turkey

Approval Date: 2005

Thesis Language: Turkish

Student: SERDAR AYÇİÇEK

Supervisor: ÖMER SUAT FİTOZ

Abstract:

SUMMARY The Role of Helical Computed Tomography in the Diagnosis of Acute Appendicitis in Pediatric Patients Purpose: To determine the diagnostic role of CT in pediatric patients with suspicion of appendicitis. Material and Methods: A total of 26 cases with clinically suspected appendicitis were included in the study. Two independent reviewers retrospectively evaluated the right lower quadrant and pelvic oriented CT examinations and compared the results with each other and ultrasound (US) studies taking surgical and pathologic findings into consideration. Diagnostic criteria like appendix diameter, appendiceal wall thickness and contrast enhancement, periappendiceal fat tissue density, appendicoliths, cecal wall thickness, free fluid, lymphadenopathy, lateroconal and perirenal fascial thickening, abscess and plastrone presence and other additional pathologies were all evaluated. Results: In 22 of the 26 pediatric cases of ages 3-18 years, there was surgically proven appendicitis. US was considered non-diagnostic in one appendicitis case due to presence of bowel-gas artifact while US findings in three cases were normal. In 4 cases which were considered normal by clinical observation, CT was also normal but false positive results were present in 2 patients with US. CT detected all the 22 appendicitis cases accurately. While presence of abscess was detected by CT in 4 cases, US detected only 2. Appendiceal wall thickening was detected in all appendicitis cases on CT. Conclusion: In the pediatric age group, the sensitivity, specificity and accuracy of CT was higher as compared to US in the diagnosis of appendicitis. Detection of a normal appendix by CT (88%) was higher than US (50%). CT examination enhances the delineation of disease extent in perforated appendicitis. Key Words: Acute abdomen, appendicitis, children, helical computed tomography, ultrasonography. 66