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Evaluation of the Appendix Base Location in Acute Appendicitis Using Sonography and its Clinical Significance |
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Kwanseop Lee, M.D. Min-Jeong Kim, M.D. Eun Young Ko, M.D. Myung Sun Hong, M.D. Eui-Yong Jeon, M.D. Hee Sung Hwang, M.D. In Jae Lee, M.D. Ik Yang, M.D. Eil Seong Lee, M.D. Bong Hwa Lee, M.D.* |
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Department of Radiology, Hallym University College of Medicine *Department of Surgery, Hallym University College of Medicine |
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PURPOSE : The purpose of this study is to investigate the location of appendiceal base using sonography in acute appendicitis
and the usefulness of the appendiceal base marking in deciding the incision site of appendectomy.
MATERIALS and METHODS : We performed appendix sonography in 813 patients and 381 patients were diagnosed as
acute appendicitis. During sonography, we marked the base of the appendix on the skin of the patients’abdomen.
After appendiceal base marking, we measured the distance from McBurney’s point to the appendiceal
base. The marking was used as the guide for incision site for appendectomy by the surgeon. Among 381 patients,
we excluded 78 patients due to nonvisualization of the cecoappendiceal junction (n = 6), pregnancy appendicitis
(n = 2), false positive appendicitis (n = 3) and no reply from the surgeon (n = 67). So we investigated
303 patients prospectively. After operation, we asked the surgeon whether the appendiceal base marking was
helpful for appendectomy or not.
RESULTS : The base of the appendix at McBurney’s point were 31%, lying within 2 cm from McBurney’s point
were 20%, within 5 cm were 28%, more than 5 cm were 21%. For the usefulness of appendiceal base marking,
95% showed good correlation with marking and surgical incision, and 5% revealed poor correlation.
CONCLUSION : The base of the appendix was located in diverse areas of the abdomen, although most frequent in the
McBurney’s point and within 2 cm from the McBurney’s point. Appendiceal base marking on the skin of the
abdomen after diagnosis of acute appendicitis could be an useful method to guide the surgeon for decision of
surgical incision site. |
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Keyword : Appendix Appendicitis Appendix, US |
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pdf파일 : 185-190이관섭.pdf
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