Abstract

ABSTRACT:
BACKGROUND:
Misdiagnosis of acute appendicitis is a common and crucial problem in general surgery, as the mortality and morbidity increase from 3 – 15 folds if appendix is perforated. Graded compression ultrasonography is one of the new diagnostic techniques that were introduced to improve the diagnostic accuracy and consequently the clinical outcome.
OBJECTIVE:
The aim of the current study is to assess the diagnostic accuracy of ultrasound in the diagnosis of suspected acute appendicitis.
METHODS:
One hundred-eighty patients admitted to the general surgical ward at Al Kindy Teaching Hospital from 1 June 2009 to 28 Feb. 2010. All patients were complaining of right iliac fossa pain and tenderness with a suspicion of acute appendicitis, a clinical assessment done for them by using modified Alvarado score (only patients with Alvarado score 5 and below were included). All patients were investigated by WBC count and general urine analysis. When the diagnosis of acute appendicitis was clinically equivocal, an abdominal ultrasound performed within 4 hours of admission. A dilated, Non- compressible appendix greater than 6 mm diameter, and edema and asymmetry of the appendicular wall were considered positive for the diagnosis of acute appendicitis. A normal appendix on histopathological examination with positive ultrasonographic findings was considered false positive result.
RESULTS:
The findings according to histopathological examination shows that 160 cases were true positive cases,14 cases were found to be true negative , 1 cases was false positive and 5 cases were false negative cases.:
Ultrasonography yielded a sensitivity rate of 96% and specificity rate of 93%.
CONCLUSION:
Ultrasound by graded compression technique provides highly accurate, sensitive and specific test for clinically equivocal acute appendicitis.
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