Usefulness and Limitations of Ultrasonographic Diagnosis for Right Lower Quadrant Pain

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 24; no. 6; pp. 1023 - 1028
• Main Authors: Nakajima, Hiroki, Takeuchi, Kunio, Tsuzuki, Yasuyuki, Ando, Tetsu, Sekihara, Masao, Hara, Takashi, Kori, Takayuki
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Abdominal Emergency Medicine 2004
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem1993.24.1023

The accuracy of ultrasonography for the diagnosis of patients with right lower quadrant (RLQ) pain was evaluated. MATERIALS AND METHODS: The diagnoses of 148 patients referred to our hospital with RLQ pain and who underwent an ultrasonography were retrospectively analyzed. Specifically, the diagnostic accuracy of ultrasonography for patients thought to have acute appendicitis, the dependence of the visualization rate on the inflammation grade, the dependence of the visualization rate on the anatomical positions of the appendix, and the diagnostic accuracy of ultrasonography in patients with RLQ pain were evaluated. RESULTS: The sensitivity and overall accuracy of the initial ultrasonography studies in patients thought to have acute appendicitis were 74.3% and 81.8%, respectively. The sensitivity and overall accuracy increased to 90.5% and to 89.9%, respectively, after a second ultrasonography study and an abdominal computed tomography (CT) scan were performed. The sensitivity and accuracy of the ultrasonography studies in patients with RLQ pain were 74.5% and 81.8%, respectively. CONCLUSIONS: Ultrasonography was a useful aid for differentiating RLQ pain. Furthermore, performing a second ultrasono-graphy study and an abdominal CT scan improved the accuracy of acute appendicitis diagnoses.