A Study To Assess The Accuracy Of Ultrasonography In Acute Appendicitis In Comparison With Laparotomy/Laparoscopic And Histopathological Findings

Abstract

Background and objectives Despite the advances in medical diagnostic, the diagnosis of acute appendicitis (AA) remains a clinical challenge which is a common emergency in surgical practice. This study was designed to determine the sensitivity, specificity, positive and negative predictive values of ultrasound for the diagnosis of AA in comparison to laparotomy/laparoscopic findings and histopathological report. Methodology The present one year hospital based study was carried out in Department of General Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi from January 2014 to December 2014. A total of 70 patients were studied. These patients were evaluated for AA by ultrasound and the findings were compared with laparoscopy/laparotomy findings and histopathological reports. Results Most of the patients were males (74.29%) and male:female ratio was 2.88:1. Nearly half of the study population (54.29%) was aged between 18 to 30 years and the mean age was 28.32 ± 13.15 years. The commonest symptom was anorexia (97.14%) and rebound tenderness (75.71%) was the commonest sign. Ultrasound findings revealed 77.14% of the patients with AA. During laparoscopy/laparotomy, AA was noted in 85.71% of the patients and histopathological report also revealed AA in 85.71%. Out of 54 patients who were diagnosed to have AA on USG, the diagnosis was confirmed in 52 (96.30%) patients on laparoscopic findings as well as histopathology (p<0.001). Conclusion and interpretation Ultrasound examination showed sensitivity, specificity and positive predictive value of 86.87% 80% and 96.30% when compared to laparotomy / laparoscopic findings and histopathological findings as a gold standard respectively. Further, the negative predictive value is 50% and diagnostic accuracy is 85.71%.