Determination of sensitivity and specificity of ultrasonography in acute appendicitis: Comparison with per-operative findings and histopathological report

Abstract

Objective: This study was under taken to compare the ultrasonographic findings with pre-operative findings and histo-pathological report and to evaluate the sensitivity, specificity, positive and negative predictive values and accuracy of ultrasonography in the diagnosis of acute appendicitis. Methods: It was a prospective study done in the department of radio-diagnosis, SCBMCH, Cuttack. Patients with provisional diagnosis of acute appendicitis were subjected to ultrasound of abdomen and pelvis. Patients with positive USG findings were followed up for pre-operative findings and histo-pathological results. All the obtained data were tabulated and subjected to statistical analysis. Results: Among the 100 cases studied, 77 cases were proved as acute appendicitis based on surgical and histopathological results. Male to female ratio was 1.5:1. The disease was found to be more prevalent in second and third decade of life. Location of affected appendix was most commonly retro caecal. Mean diameter of the appendix was 8.56 mm. Target sign and non-compressible bowel loop was the most commonly detected ultrasonographic sign and the ultrasonographic sensitivity was 96.1% and specificity was 95.65% in our study. Conclusion: High resolution sonography with graded compression is a very useful diagnostic tool for diagnosis of appendicitis in problematic cases and in women in their reproductive period. It is also helpful in detecting complications of appendicitis and other abdominal diseases that mimic acute appendicitis.