ABSTRACT
The accurate clinical diagnosis of acute appendicitis is difficult, and many techniques have been suggested to improve diagnostic accuracy. In this study serial total leucocyte counts, C-reactive protein [CRP] concentrations, st and ard ultrasound [US] machine and plain abdominal X-ray were performed. The sensitivity and specificity of serial leucocyte counts in acute appendicitis were 92 and 100%, and for CRP concentrations 69 and 75%, respectively. US was superior to plain X-ray with a sensitivity and specificity of 89 and 96%, respectively, as compared with plain X-ray with 48 and 93%, respectively. The negative appendicectomy rate was 8%. It is suggested that in patient with equivocal clinical findings, clinical observation, combined with serial leucocyte counts may improve decision making. In the alternative diagnosis, plain X-ray was superior to US due to the prevalence of intestinal diseases, ureteric calculi and basal pneumonia which were best shown in plain X-ray. US was, however, most useful in detecting female pelvic pathology. It is prudent to perform both ultrasound and plain abdominal X-ray, while the patient is in the Radiodiagnostic Department