Pemeriksaan Ultrasonografi dan CT-Scan untuk Diagnosis Apendisitis Akut pada Anak

Suryadi Susanto

doi:10.36452/jkdoktmeditek.v27i1.1956

Authors

Suryadi Susanto Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Kristen Krida Wacana, Jakarta, Indonesia

DOI:

https://doi.org/10.36452/jkdoktmeditek.v27i1.1956

Keywords:

apendisitis akut anak, ultrosonografi, CT-scan

Abstract

Apendisitis akut merupakan suatu keadaan tersering yang memerlukan tindakan bedah pada anak. Ketepatan untuk menentukan diagnosis dan intervensi bedah berhubungan erat dengan luaran akhir. Diagnosis apendisitis akut dengan keluhan yang tidak spesifik sering membingungkan. Pendekatan diagnosis seperti anamnesis, pemeriksaan fisik, dan pemeriksaan laboratorium rutin tidak selalu akurat. Pemeriksaan diagnostik pencitraan seperti ultrasonografi (USG) dan computed tomography scan (CT-scan) sering digunakan untuk membantu menegakkan diagnosis. Tujuan pemeriksaan pencitraan untuk mengkonfirmasi atau menyingkirkan diagnosis apendisitis akut serta menentukan apendisitis tanpa atau dengan komplikasi. Keterlambatan menentukan diagnosis berhubungan erat dengan meningkatnya angka kesakitan, angka kematian, dan biaya perawatan. Komplikasi dapat berupa perforasi, abses abdominal, atau kematian. Perforasi umumnya terjadi pada usia anak dan remaja dengan angka kejadian berkisar 17-40%. Secara umum angka kematian akibat apendisitis kurang dari 1% dan meningkat 5-15% pada anak dan remaja. Pemeriksaan USG memiliki sensitivitas dan spesifisitas yang sama baiknya dengan pemeriksaan CT-scan.

References

Doria AS, Moineddin R, Kellenberger CJ. US or CT for diagnosis of appendicitis in children and adults? a meta-analysis. Radiology. 2006;241:83–94.

Kaiser, Frenckner B, Jorulf HK. Suspected acute appendicitis in children: US and CT—a prospective randomized study. Radiology. 2002;223:633–8.

Randen A, Bipat S, Zwinderman AH, Ubbink DT, Stoker J, Boermeester MA. Acute appendicitis: meta analysis of diagnostic performance of CT and graded compression US related to prevalence of disease. Radiology. 2008;249:97-106.

Keyzer C, Zalcman M, De Maertelaer V. Comparison of US and unenhanced multi-detector row CT in patients suspected of having acute appendicitis. Radiology. 2005;236:527–34.

Koo HS, Kim HC, Yang DM, Kim SW, Park SJ, Ryu JK. Does computed tomography have any additional value after sonography in patients with suspected acute appendicitis? J Ultrasound Med. 2013; 32:1397–1403.

Strouse PJ. Pediatric apendisitis:an argument for US. Radiology. 2010;255:8-13.

Pacharn P, Ying J, Linam LE, Brody AS, Babcock DS. Sonography in the evaluation of acute apendisitis. J Ultrasound Med. 2010;29:1749-55.

Lu YT, Chen PC, Huang YH, Huang FC. Making a decision between acute appendicitis and acute gastroenteritis. Children. 2020;7:176

Choi JY, Ryoo E, Hyun Jo J, Hann T, Kim SM. Risk factors of delayed diagnosis of acute appendicitis in children: for early detection of acute appendicitis. Korean J Pediatr. 2016;59:368-73.

Reginelli A, Mandato Y, Solazzo A, Berrittto D, Iacobellis F, Grassi R. Errors in the radiological evaluation of the alimentary tract: part II. Semin Ultraosund CT MR. 2012;33:308-17.

Stabile IAA, Lorusso F, Niccoli AA, Di Maggio P, Fonio P, Losco M, et al. Multidetector CT for assessment of the groin region. Recenti Prog Med. 2012;103:483-8.

Almaramhy HH. Acute appendicitis in young children less than 5 years: review article. Italian Journal of Pediatrics. 2017;43:15.

George T, Babu RKN, Thomas PT. Reliability of ultrasonography in the diagnosis of acute appendicitis. Int Surg J. 2016;3:59-61.

Anandan S, Marino RV. Use of computed tomography in diagnosing appendicitis: redundant, expensive, toxic and potentialy unnecessary. J Am Osteopath Assoc. 2012;112:121-5.

Gosain A, Willliams RF, Blakely ML. Distinguishing acute form ruptured appendicitis preoperatively in pediatric patient. Adv Surg. 2010;44:73-85.

Sargar KM, Siegel MJ. Sonography of acute appendicitis and its mimics in children. Indian Journal of Radiology and Imaging. 2014;24:163-70.

Fields JM, Davis J, Alsup C, Bates A, Au A, Adhikari Srikar, Farrell I. Accuracy of point of care ultrasonography for diagnosing acute appendicitis: a systematic review and meta-analysis. Academic Emergency Medicine. 2017;24:1124–36.

Karabulut N, Kiroglu Y, Herek D, Kocak TB, Erdur B. Feasibility of low-dose unenhanced multi-detector CT in patients with suspected acute appendicitis: comparison with sonography. Clinical Imaging. 2013;38:296-301.

Podany AB, Tsai AY, Dillon PW. Acute appendicitis in pediatric patients: an updated narrative review. J Clin Gastroenterol Treat. 2017;3:042.

Hernanz-Schulman M. CT and US in the diagnosis of appendicitis: an argument for CT. Radiology. 2010;255:3-7.

Russell WS, Schuh A, Hill JG, Hebra A, Cin RA, Smith C, et al. Clinical practice guidelines for pediatric appendicitis evaluation can decrease Computed Tomography utilization while maintaining diagnostic accuracy. Pediatric Emergency Care. 2013;29:568-73.

Papandria D, Goldstein SD, Rhee D, Salazar JH. Risk of perforation increases with delay in recognition and surgery for acute appendicitis. J Surg Res. 2013;184:723-9.

Wan MJ, Krahan M, Ungar WJ. Acute appendicitis in young children: cost effectiveness of US versus CT in diagnosis. Radiology. 2009;250:378-86.