HYPERDIAGNOSIS OF ACUTE APPENDICITIS IN FEMALE PATIENTS WITH A REDUCED BODY WEIGHT

Аннотация

Полный текст

Background. Hyperdiagnosis of acute appendicitis is actual to this day. It is known that indications for appendectomy are such symptoms as local soreness and tension in right iliac region in combination with leukocytosis. Often, patients undergo appendectomy, appendicitis without suffering. Number of unchanged processes removed during operation, and now is 20-30%. One of the reasons for hyper-diagnosis is the hypermobility of the right kidney in girls with a reduced body weight. According to the Russian Target Groups Index of 2011, 18% of girls aged 16-19 have a reduced body weight, and 11% have an age of 20-24 years. When examining such patients, the pain was determined for palpation in the right ileal region 3-4 cm medial to the point of McBurney. Aim. The purpose of the study: to determine the ratio of patients with a moving kidney with preliminary diagnosis of «Acute appendicitis» Material and Methods. We examined 138 patients aged 16-24 years who had reduced body weight with preliminary diagnosis of «Acute appendicitis». Results and Discussion. In 84 patients with careful deep palpation, the lower pole of the right kidney was found medial to the point of McBurney, which was 60.8% in study group. Painful reaction to palpation was also observed. Ultrasound examination further confirmed presence of kidney mobility. Diagnosis «Acute appendicitis» was confirmed only in 23%. Conclusions. When examining girls with reduced body weight, careful deep palpation in the right iliac region should be paid in conjunction with ultrasound examination of the abdominal cavity.