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Fazal Ahmed
Mohammad Tahir
Qazi Tahir Uddin
Ejaz Ahmed Khan
Nafisa Batool Tahir
Shahid sardar
Bakhtier Ahmad



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.


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.


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

How to Cite
Ahmed, F., M. Tahir, Q. T. Uddin, E. A. Khan, N. B. Tahir, S. sardar, and B. Ahmad. “ULTRASONOGRAGHY: A GOOD AID TO THE CLINICAL DIAGNOSIS OF ACUTE APPENDICITIS”. KHYBER MEDICAL UNIVERSITY JOURNAL, vol. 4, no. 4, Dec. 2012, pp. 165-9, https://www.kmuj.kmu.edu.pk/article/view/10183.
Original Articles
Author Biographies

Fazal Ahmed, Khyber Medical University Institute of Medical Sciences Kohat

Assistant Professor Department of Sugery

Mohammad Tahir, Khyber Medical University Institute of Medical Sciences Kohat

Assistant Professor Surgery

Qazi Tahir Uddin, Khyber Medical University Institute of Medical Sciences Kohat

Assistant Professor Surgery

Ejaz Ahmed Khan, Khyber Medical University Institute of Medical Sciences Kohat

Assistant Professor Community Medicine

Nafisa Batool Tahir, Khyber Medical University Institute of Medical Sciences Kohat

Assistant Professor Medicine

Shahid sardar, KIMS KOHAT

Assistant Professor Radiology KIMS KOHAT

Bakhtier Ahmad, King Abdulaziz Medical City(National Guard Hospital) Al Ahsa

Consultant Radiologist Medical Imaging Department


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;


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);


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:




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.

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