ULTRASONOGRAGHY: A GOOD AID TO THE CLINICAL DIAGNOSIS OF ACUTE APPENDICITIS
Main Article Content
Abstract
Objective:
to evaluate the value of ultrasonography in the diagnosis of acute-appendicitis, in clinically suspected cases.
Methodology: This prospective observational study was carried out at DHQ Teaching hospital, Khyber Medical University,Institute of Medical Sciences Kohat, Pakistan from Feb-2009 to Nov-2011. This study included 150 patients with a clinicalsuspicion of acute-appendicitis. The ultrasound findings were compared with histopathological outcome of the case,which was taken as gold standard. In the radiology department, color Doppler ultra sound machine, Accucie Toshibawith a 7.5 MHz, abdominal probe was used. All the exams were performed by a single senior radiologist.
Results:
Out of 150 patients, 112 (74.7%) were male and 38 (25.3%) were female. Age ranged from 12 to 60 years. Onthe basis of ultrasonography, 100 (66.7%) patients were labeled as positive for acute-appendicitis and 50 (33.3%) patientsas negative for acute-appendicitis. Out of 100 positive patients, 79% patients were confirmed as acute-appendicitis onhistopathology and 21% had normal appendix on histopathology. Out of 50 negative patients, 12 (24%) patients had rightureteric calculus and 6 (12%) patients had acute cholecystitis while 5 (10%) patients were explored later on becauseof persistent pain and progressing symptoms and a diagnosis of acute-appendicitis was confirmed on histopathology.
Conclusion:
In clinically suspected cases of pain right iliac fossa, the use of ultrasonography is valuable to establishacute appendicitis or alternate diagnosis. It can be recommended as a valuable screening tool in clinically suspectedcases of acute-appendicitis.
Key Words:
Ultrasonography, acute appendicitis, histopathology.
This article may be cited as:
Ahmed F, Tahir M, Uddin QT, Khan EA, Tahir NB, Sardar S, et al. Ultrasonograghy: Agood aid to the clinical diagnosis of acute appendicitis. Khyber Med Univ J 2012; 4(4): 165-169.
Article Details
Work published in KMUJ is licensed under a
Creative Commons Attribution 4.0 License
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
References
Baensler EHL Jeffery J.R.B. Liang FF. Sonography in
patients with suspected acute appendicitis. Value in
establishing alternative diagnosis. Am J Roentgenol
; 152: 49-52.
Boubalos A. diagnosis of epigastric appendicitis based
on sonographic findings. Am J Roentgenol 1992;
:222.
Chan I, Bicknell SG, Graham M, Utility and Diagnostic
accuracy of sonography in detecting appendicitis in
a community hospital. Am J Roentgen. 2005; 186(6);
-12.
Garba S, Ahmed A. Appendicitis in the Elderly, Appendicitis
- A Collection of Essays from Around the World,
Dr. Anthony Lander (Ed.), 2012; InTech, Available from:
http://www.intechopen.com/books/appendicitis-a-collection-
of-essays-from-around-the-world/appendicitis-
inthe-elderly
Naoum JJ, Mileski WJ, Daller JA. The use of abdominal
computed tomography scan decreases the frequency
of misdiagnosis in cases of suspected appendicitis. Am
J Surg 2002; 184:587-9.
Patrick DA, Janik JE, Janik JS. Increased CT scan
utilization does not improve the diagnostic accuracy of
appendicitis in children. J Pediatr Surg 2003; 38:659-62.
Mardan MAA, Mufti TS, Khattak IU, Chilkunda N, Alshayeb
AA, Mohammad AM, et al. Role of ultrasound in acute appendicitis. J Ayub Med Coll 2007;19(3):72-9.
Qureshi I A, Tarin B A, Shafiq M. Role of Ultrasonography
in clinically suspected cases of Acute Appendicitis. Pak
Armed Forces Med J 2001;51(2):90-3.
Siddiqui ZR, Khaliq T, Shah SA. A new simple scoring
system for the diagnosis of acute appendicitis. J Pak
Med Stud 2011; 1(2): 32-7.
Dholia KR, Baloch I, Shaikh S A, Soomro S H, Abro
A. Total and differential leucocyte count (TLC and DLC)
in cases of acute appendicitis: A study of 200 cases at
Chandka Medical College Hospital Larkana. Med Channel
; 16(2):284-6.
Franke C, Bohner H, Yang Q, Ohmann C, Rohr HD. Ultrasonography for the diagnosis of acute appendicitis:
Results of a prospective multicenter trial. World J Surg
; 23(2); 141-6.
Haydan CK. Kuchelmeister J. Liposcamp TS. Sonography
of acute appendicitis in childhood. Perforation verses non perforation. J Ultrasound Med 1992; 11: 209-16.
Lee JH, Jeong YK, Hwang JC, Ham SY, Yang SO. Graded
compression sonography with adjutant use of posterior
compression technique in the sonographic diagnosis of
acute appendicitis. Am J Roentgenol 2002; 178(4):863-8.
Lee JH, Jeong YK, Park KB, Park JK, Jeong AK, Hwang
GC. Operator-dependent techniques for graded compression
appendicitis. Am J Roentgenol 2005; 184(1):91-7.
Lim HK Bar. SH Se OGS. Diagnosis of Acute appendicitis
in pregnant women Value sonography. Am J Roentgenol
; 159: 539-2.
Nghiem HV, Jeffery JRB. Acute appendicitis confirmed
to appendiceal tip. J Ultrasound Med 1992; 11: 205-7.
Ooms HW, Koumans RK, Ho Kang you PJ, Puylaert JB.
Ultrasonography in the diagnosis of acute appendicitis.
Br J Surg 1991; 78(3); 315-8.
Poole G V. Appendicitis: The diagnostic challenge conclusive.Am Surgeons 1998; 5 4: 609-12.
Puylaert JB. Acute appendicitis: US evaluation using
graded compression. Radiology. 1986; 158(2): 355-60.
Ripollés T, Martinez-Perez MJ, Morote V, Solaz J.
Diseases that simulate acute appendicitis on ultrasonography.
Br J Radial 1998; 71(841): 94-8.
Rodriguez DP, Wargas S, Callahan MI, Zurakowski D,
Taylor GA. Appendicitis in young children; imaging
experience and clinical outcomes. Am J Roentgenol
; 186(4); 1158-64.
Lee S, Walsh AJ, Ho HS. Computed tomography and
ultrasonography do not improve and may delay the
diagnosis and treatment of acute appendicitis. Arc Surg
; 136(5); 556-62.
Schuler JG, Shortsleeve MJ, Goldenson RS, Perez-Rossello
JM, Perlmutter RA, Thorsten A. Is there a role for
abdominal computed tomographic scan in appendicitis?
Arch Surg 1998;133 (4); 373-6.
Zielke A, Hasse C, Sitter H, Rothmund M. Influence of
ultrasound on clinical decision making in acute appendicitis:
a prospective study. Eur J Surg 1998; 164(3):201-9.