Sonographic Evaluation of Acute Appendicitis -A Study at a Tertiary Care Hospital of Tribal, Hilly, Wayanad in Kerala
Annals of International medical and Dental Research
Acute appendicitis (AA) is one of the most frequent causes of an acute abdomen requiring emergency surgery. Classically, the clinical findings consist of periumbilical pain migrating to the right lower quadrant, accompanied by fever and leukocytosis. However, the classic signs are not always present, and symptoms can be nonspecific and overlap with other causes of abdominal pain. While the clinical diagnosis may be straightforward in patients who present with classic signs and symptoms,
... d symptoms, atypical presentations may result in diagnostic confusion and delay in treatment. Among imaging methods, Ultrasound (US) is a valuable tool, which is widely available, can be performed at the bedside, does not use ionizing radiation, is relatively inexpensive, and may show evidence of other causes of abdominal pain. Methods: We evaluated the role of ultrasound in the diagnosis of AA, at a tertiary care hospital of tribal, hilly, Wayanad in Kerala, involving 224 patients from Jan 2015 to July 2016. Ultrasound findings were finally compared with surgical / pathological report of appendices removed at surgery. Results: The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of ultrasound in diagnosis of AA, in our study were found to be 99.2 %, 76.7 %, 87.2% , 98.5% and 90.6 % respectively. Conclusion: Although the sensitivity, specificity, and accuracy of sonography vary greatly in studies evaluating the imaging diagnosis of acute appendicitis, it should be the first imaging modality when there is clinical concern for acute appendicitis.