Diagnostic value of ultrasonography in appendicitis.
BACKGROUND
Clinical diagnosis of appendicitis is often difficult in atypical patients.


OBJECTIVE
The authors aim to determine the diagnostic accuracy of ultrasonography (US) for acute appendicitis.


METHODS
121 consecutive patients with right lower abdomen pain were evaluated. Of them, 25 were excluded due to not having performed a preoperative US and 5 were obese (Body Mass Index > 30). A total of 91 patients were evaluated. The patients were assessed clinically and radiologically. Blood and urine analysis was carried out in all patients. US was performed with a Toshiba Fomio 8 brand machine with 3.75 and 8 MHz linear probes. Patients underwent an operation and an appendicectomy was done. Specimens were sent for histopathology to confirm appendicitis.


RESULTS
Ultrasound supported the diagnosis of acute appendicitis in 58 (63.7%) patients. In the US with positive findings, 55 patients (94.8%) had inflamed appendices on histopathology and 5 (8.6%) had normal appendices. The overall sensitivity of ultrasonography was 71.4% and specificity was 78.5%. Positive predictive value (PPV), negative predictive value (NPV) and the diagnostic accuracy of ultrasonography are 94.8%, 33.3%, and 72.5% respectively.


CONCLUSIONS
All diagnostic tests are adjunctive to the clinician. US should be the first step in the care of patients with right lower abdominal pain after the physical examination.
Ege University School of Medicine, Department of General Surgery, Izmir, Turkey. taylan.ozgur.sezer@ege.edu.tr
Taylan O
TO
Sezer
Burcin
B
Gulece
Nihat
N
Zalluhoglu
Mehmet
M
Gorgun
Selami
S
Dogan
D015746:Abdominal Pain / Q000000981:diagnostic imaging / Q000209:etiology; D000293:Adolescent; D000328:Adult; D001062:Appendectomy; D001064:Appendicitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D001706:Biopsy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D055815:Young Adult