Evaluation of Ultrasonography in the Diagnosis of Acute Appendicitis with Histopathology as Gold Standard

Abstract

Background: Acute appendicitis is the most common surgical abdominal emergency with a life time prevalence of 1 to 7 individuals. Because the clinical diagnosis of acute appendicitis remains a challenge to surgeons, so different aids were introduced like different scoring systems, computer aided programs, ultrasonography, computerized tomography, Magnetic resonance imaging, Gastrointestinal tract contrast studies and laparoscopy to improve the diagnostic accuracy.

Objective: To evaluate ultrasound in the diagnosis of acute appendicitis in those patients clinically diagnosed with histopathology as gold standard.

Methods: A cross sectional study carried in Al-kindy Teaching Hospital through one year duration from 1^st of may2015 to1^st of May 2016. All included patients were subjected to ultrasonographic examination to assess the vermiform appendix with a graded compression technique. The Ultrasonography findings were recorded as positive and negative for acute appendicitis.

All the appendices removed from the study patients were sent for histopathological study. Statistical analysis done using (SPSS) version 21, Chi-sequare test used for categorical variables and t-test was used to compare between two means. Level of significance (P value) set at ≤ 0.05.

Results: A total of 215 patients with suspected appendicitis, males 112 (52.09%) and females 103(47.9%) were included in present study. The validity results of ultrasound in comparison with histopathology findings were as following; accuracy 86.5%, sensitivity 86.5%, specificity 86.6%, positive predictive value 99.8% and negative predictive value 32.5%.

Conclusion: The ultrasonography has a good accuracy, sensitivity and specificity in diagnosing acute appendicitis.