Advantage of ultrasonography in the diagnosis of acute appendicitis at Al-Karama Teaching Hospital
DOI:
https://doi.org/10.18203/2349-2902.isj20190467Keywords:
Accuracy, Appendicitis, Iraq, Ultrasonography, ValidityAbstract
Background: The clinical diagnosis of acute appendicitis remains a challenge to surgeons. Different aids were introduced to improve the diagnostic accuracy. Among these modalities, ultrasonography is simple, easily available, non-invasive, convenient and cost effective. The aim of the study was to determine the validity of ultrasound in diagnosis of the acute appendicitis in those with clinically diagnosed patients.
Methods: A cross sectional study was carried out in Al-Karama teaching hospital for thirty months from the period of 1st June 2016 to 1st December 2018. All patients with suspected appendicitis underwent clinical evaluation then sent for US. Results of surgeries, where relevant, were compared against US results. Positive and negative appendices on histopathology were regarded in accordance to the criteria which was negative appendectomy was defined as normal looking appendix and absence of acute inflammation on histopathology while positive cases included appendices showing acute inflammatory changes. Sensitivity, specificity and overall accuracy was calculated.
Results: A total of 435 patients with suspected appendicitis, males 224 (51.49%) and females 211 (48.50%) were included in present study. There were no significant differences between patients with positive and negative histopathology findings regarding presenting symptoms. There was a significant association between (cough sign, localized tenderness sign and pointing sign) and patients with positive histopathology findings. Regarding to the validity results of ultrasound in comparison to histopathology findings were accuracy 87.6%, sensitivity 87.8%, specificity 85.3%, positive predictive value 98.6% and negative predictive value 62.8%.
Conclusions: The ultrasonography had a good accuracy, sensitivity and specificity in diagnosing acute appendicitis cases. Negative with ultrasonography results should be re-examined with different diagnostic technique like CT-scan.
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