Ultrasound Value in Diagnosis of Acute Appendicitis at Al-diwaniyah Teaching Hospital-Iraq

Abstract

Background: Ultrasound has been widely available and usable imaging technique help in assessment anddiagnosis of various diseases. The use of ultrasound as diagnostic tool for diagnosis of appendicitis has beenestablished, but the real value of use of ultrasound not clearly observed, the aim of our study to clarify thenegativity of the predictive value of ultrasound study for acute appendicitis (NVP).Method: Ultrasound study of the abdomen with focusing on right iliac fossa done for 100 patient clinicallysuspected to have acute appendicitis and a scale of one to three given for sonographic results range fromnegative (score 1) to confirmed appendicitis (score 3), the result compared with the CT – scan finding andspecimen pathology after surgical intervention.Result: Seventy four (74) patient were negative by ultrasound, while twenty six (26) patient has score of 3ultrasonic features of acute appendicitis, CT scan examination with contrast adding another ten (10) patientproved to have appendicitis (i.e changing from negative to positive appendicitis by CT findings) and fifteen(15) patient with other diagnosis or discharged, so total positive cases where thirty six (36) patients whomunderwent surgical intervention, from those were thirty (30) patient confirmed appendicitis by pathologicalresult (83%), So the negative predictive value for the ultrasound diagnosis of appendicitis (NVP = 95.1%).Conclusions: Ultrasound had an overall lower sensitivity in diagnosing appendicitis in our study, butwith high specificity, however, with various studies when the appendix was not clearly identified, CT-scanassessment should be considered .