Abstract:
Background: To evaluate the sensitivity and specificity of ultrasound for the diagnosis of acute appendicitis, described in international literature, in local setting. Methods: This prospective study was done in Holy Family Hospital and Rawalpindi General Hospital, Rawalpindi over a period of six months. A total of 30 patients (18 male and 12 females) with suspected clinical diagnosis of acute appendicitis were included in the study. All examinations were performed with power vision 6000 power/color Doppler sonographic machine, using 3.5 MHz convex probe, followed by 7-10 MHz linear high resolution ultrasound probe. Inflamed appendix was identified by the following criteria: A finger shaped, blind ending, non-compressible, non-peristaltic structure on longitudinal image and target appearance on transverse scanning with minimum transverse diameter more than 7 mm. Post surgical evaluation was done with morphology and in uneqiuvocal patients, with histopathology. Results: The mean age of patients comprising our study group was 27.5 years. Out of 30 patients, 28 (93.3%) revealed positive ultrasonographic findings of appendicitis. 26 of total were true positive (86.6%), and proven to have acute appendicitis on post surgical morphology/ histopathology, while two proved to be false positive (6.6%) and showed negative postsurgical/histopathology findings. The remaining two (6.6%) patients proved not to have acute appendicitis both on ultrasonography and following surgery. One had hydrosalpinx and the other turned out to be suffering from Crohn`s ileitis. The ultrasonographic findings of routine 3.5 MHz convex probe were compared with high resolution 5-7 MHz linear probe. On routine ultrasonography, 18 patients (60%) were positive. - With high resolution ultrasonography, the sensitivity and specificity were considerably higher since a further ten patients were diagnosed to be suffering from acute appendicitis. Conclusions: All patients with a suspicion of acute appendicitis should routinely undergo abdominal ultrasonography performed by an experienced radiologist to confirm the diagnosis and prevent negative appendectomy. There is a higher sensitivity and specificity of high resolution ultrasound compared to routine abdominal ultrasound examination.
Page(s):
87-89
DOI:
DOI not available
Published:
Journal: Journal of Rawalpindi Medical College, Volume: 8, Issue: 2, Year: 2004