A Review of Radiological Investigations in Cases of Acute Appendicitis in a Tertiary Care Hospital

Abstract

INTRODUCTION Acute appendicitis is the most common non-traumatic surgical emergency and early diagnosis and management are crucial to decrease morbidity and mortality. There is a variety of scoring systems and radiological investigations that have been used in the diagnosis of acute appendicitis. Hence, the aim of this study is to assess the diagnostic approach in patients with suspected appendicitis in a tertiary care hospital, focusing on the radiological burden. METHODS This is a cross-sectional study reviewing the electronic and manual medical records of all adult patients admitted with the diagnosis of acute appendicitis between January 2018 and December 2018 in Salmaniya Medical Complex, Manama, Bahrain. A review of the method of diagnosis (clinical, ultrasound, computed tomography, or others) was done, with a comparison to histopathological results in those that underwent surgical intervention to determine sensitivity and specificity. RESULTS In the study period, 488 patients were admitted with acute appendicitis; out of these, 461 underwent surgical intervention. A total of 66 CT scans and 148 ultrasounds were conducted for these patients, out of which 57% of ultrasounds and 86% of CT scans accurately diagnosed acute appendicitis based on histopathological diagnosis, resulting in a sensitivity of 65% and 92%, respectively, and a specificity of 56% and 25%, respectively. CONCLUSION The most accurate method of diagnosis of acute appendicitis (highest sensitivity) is CT scanning. However, a prospective study with a detailed assessment of complications of appendicitis is recommended.