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DOI: 10.1055/s-2006-925419
Appendizitisdiagnostik im Kindesalter
Diagnosis of Appendicitis in ChildhoodPublication History
Publication Date:
26 June 2006 (online)
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Zusammenfassung
Die klinische Diagnose einer Appendizitis im Kindesalter ist schwierig, da 30 - 40 % der Patienten eine atypische Symptomatik aufweisen. Eine präoperative Bildgebung verbessert die diagnostische Genauigkeit deutlich und reduziert damit die Zahl unnötiger Operationen, ohne dass durch eine zeitliche Verzögerung oder falsch negative Befunde die Anzahl der Perforationen ansteigt. In der Hand erfahrener Untersucher ist bei Kindern die Sonographie wegen der hervorragenden Ergebnisse, der fehlenden Strahlenexposition und der raschen Verfügbarkeit die Methode der ersten Wahl. Im Gegensatz zu Nordamerika spielt in Europa die Computertomographie bei dieser Fragestellung eine untergeordnete Rolle. Im vorliegenden Artikel soll daher speziell auf die Sonographie der Appendizitis im Kindesalter eingegangen werden. Es werden exemplarische Beispiele für normale und entzündete Appendizes präsentiert und mögliche Fallstricke der Diagnostik diskutiert.
Abstract
In childhood the clinical diagnosis of appendicitis is difficult because 30 - 40 % of patients present with atypical symptoms. Preoperative imaging clearly improves diagnosis and reduces the number of unnecessary surgery without increasing the number of perforations caused by time delay or false negative results. In the hands of an experienced examiner ultrasound is the imaging modality of choice because of the lack of ionizing radiation and the constant availability. In contrast to North America computed tomography only plays a minor role in most European countries and is reserved to complicated or unclear cases. The following article therefore deals with the sonographic diagnosis of appendicitis in children. Examples of normal and pathologic appendices are presented and reasons for false positive and negative results will be discussed.
Key words
Appendix; Appendicitis; Ultrasound; Children; Gastrointestinal tract
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Prof. Dr. Helmut Hahn
Kinderradiologie · Institut für Diagnostische und Interventionelle Radiologie · Klinikum München-Schwabing · Kinderklinik der TU München
Kölner Platz 1 · 80804 München
Phone: 089 3068-2270
Fax: 089 3068 3818
Email: H.Hahn@lrz.tum.de