Læknablaðið - 15.06.1996, Blaðsíða 43

LÆKNABLAÐIÐ 1996; 82
465
Eru tengsl á milli húðhita og
botnlangabólgu?
Framskyggn rannsókn á spágildi hefðbundinna rannsókna
og húðhita fyrir bráðri botnlangabólgu
Valgeröur Árný Rúnarsdóttir, Tómas Guðbjartsson, Jónas Magnússon
Rúnarsdóttir VÁ, Guðbjartsson T, Magnússon J
Is there a connection between skin temperature and
appendicitis?
A prospective study on the predictive value of tradi-
tional tests and skin temperature for acute appcndi-
citis
Læknablaðið 1996; 82: 465-70
Introduction: Appendicitis is a common disease, still
its diagnosis can be difficult. Of resected appendic-
es, every fifth to sixth is histologically normal. It has
been suggested that local skin temperature could be
helpful to diagnose appendicitis. The hypothesis was
that skin temperature above an inflamed appendix
was higher than elsewhere.
Material and methods: Patients suspected of acute
appendicitis admitted to Landspítalinn University
Hospital, February through June 1993, were en-
rolled. Thirty six patients, 20 males and 16 females,
aged 12 to 77, average 29, entered the study. Skin
temperature was measured over McBurney’s point
and at a comparable spot on the left side of the
abdomen. Beside the skin temperature there were
also noted some symptoms from the history and
examination and some lab results. For each of these
variables sensitivity, specificity and prospective val-
ues for appendicitis, were calculated.
Results: Of those 36 patients, 27 underwent surgery,
22 had appendicitis but 14 did not. Six of the patients
had >0.5° C higher temperature at McBumey’s
point but only two of them had appendicitis. The
other 30 patients did not have that temperature
Frá handlækningadeild Landspítalans og læknadeild Há-
skóla íslands. Fyrirspurnir, bréfaskipti: Valgeröur Á. Rún-
arsdóttir, lyflækningadeild Landspítalans, 101 Reykjavík.
difference but still 16 of them had appendicitis. The
predictive value of a positive and a negative test was
33% each, for skin temperature measurements, sen-
sitivity was 9% and specificity 71%. These results do
not suggest any connections between skin temper-
ature and appendicitis and therefore the test is use-
less for appendicitis in our opinion. White blood
cells count showed the best results in this study, with
prospective value of a positive test 91%, prospective
value of a negative test 86%, sensitivity 91% and
specificity 86%. Other traditional tests and symp-
toms turned out to be useless individually in evaluat-
ing patients suspected of appendicitis.
Conclusion: Skin temperature measurement is un-
fortunately an useless diagnostic tool. It is sobering
to see that the traditional tests and symptoms for
appendicitis are nearly useless too. On the other
hand it is fascinating and challenging to know that
the diagnosis of this common disease is still depend-
ent on the clinical judgement of the patient’s physi-
cian.
Ágrip
Inngangur: Botnlangabólga er algengur
sjúkdómur sem þó er ekki einfalt að greina.
Fimmti til sjötti hver grunsamlegur botnlangi
er tekinn óbólginn. Vegna ábendinga um hugs-
anlega gagnsemi húðhitamælinga var gerð
framskyggn rannsókn þar sem mældur var húð-
hiti yfir McBurneys depli og samsvarandi stað
vinstra megin á kviði hjá sjúklingum sem voru
grunaðir um bráða botnlangabólgu. Tilgátan
var að hiti yfir bólgnum botnlanga væri að
minnsta kosti 0,5°C hærri en annars staðar á
húðinni.
Efniviður og aðferðir: Sjúklingar sem komu
á bráðamóttöku Landspítalans grunaðir um