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The Utility of Appendicogram by Barium Swallow to Diagnosis of Acute Appendicitis (Kegunaan Apendikogram Barium Per Oral Dalam Menegakkan Diagnosis Apendisitis Akut)
To diagnose acute appendicitis is not always easy, especially in cases with atypical findings. Radiologic examination of appendix after berium swallow which is called appendicogram may of value to establish the diagnosis. A prospective study has been done in Tebet Hospital Jakarta to evaluate the utility of appendicogram in identifying patients with acute appendicitis. A total of 438 consecutive patients (175 men and 263 women) who had atypical appendicitis were investigated. To obtain the appendicogram, supine, prone and left lateral decubitus radiographs of the abdomen were performed 12 hours after swallowing 100 cc solution of 30 percent barium sulphate. Appendicograms with non filling appendix (negative appendicogram) were regarded as acute appendicitis, appendicograms with partial filling (partial appendicogram) were suspected as appendicitis, and those with totally filled appendix (positive appendicogram) were regarded as normal appendix. Patient diagnosed radiologically as acute appendicitis were confirmed by operation and pathology examination. There were 337 patients who had negative appendicogram and 266 of them underwent appendectomy, 82 patients had partial appendicogram, 54 of them were operated on, 19 patients had normal appendiogram and none of them received surgery. There were 320 patients who underwent aperation, 296 (92.5 percent) of them were confirmed by pathology reports as acute appendicitis. Thus the diagnosis accuracy was 92.5 percent. Total diagnostic error was 7.5 percent; diagnostic error in women was 6.9 percent. It is concluded that appendicogram is very useful in the diagnosis of acute appendicitis, because it is a simple test and can show the visulatization of the appendix with a high degree of accuracy.
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