ABSTRACT
The clinically equivocal acute appendicitis remains a diagnostic problem. The aim of this study was to assess the diagnostic accuracy of ultrasonography and the classical clinical factors employed in the diagnosis of suspected acute appendicitis. This study included 182 patients presenting with equivocal acute appendicitis, 88 patients [48.4%] were males and 94 patients [51.6%] were females. The age of the patients ranged from 6 to 64 years [mean: 24.3 +/- 15.3 years]. The clinical, radiological and ultrasonographic data of all patients were collected. One hundred and ten patients [60.4%] had histologically confirmed appendicitis. After analysis of the possible association between the diagnostic variables recorded and the presence of appendicitis, 9 variables were found to be significant. UItrasonography displayed the greatest diagnostic weight, with a sensitivity of 85.5%, specificity of 94.4%, and accuracy of 89%. Out of the clinical data, localization of pain in the right iliac fossa and total leucocytosis showed the greatest diagnostic weights over the others. Localization of pain in the right iliac fossa showed an 84% sensitivity. Specificity of 50%, and accuracy of 70%. Total leucocytosis showed an 81% sensitivity, specificity of 49%, and accuracy of 68%. It was concluded that ultrasonography increases the diagnostic accuracy in patients with suspected acute appendicitis