RESUMO
Introduction: The diagnosis of acute appendicitis has essentially been clinical, but USG abdomen has been said to be highly accurate in diagnosing AA. The surgeon’s perspective may not always be the same. Materialsand methods: Appendectomy data of 106 patients from two hospitals of Kangra region was retrospectively analysed. The data was collected for age, sex, initial pre-operative diagnosis, USG findings, intra-operative findings, Histo-pathological examination (HPE) report, post operative hospital stay. Observations:It revealed a sensitivity of about 54% and specificity of 100% for diagnosing AA with the help of USG abdomen. AA was seen most commonly in males as compared to females. Mean age of presentation was 29.34 +/-14.4 years. Mean hospital stay was 3.68 +/-2.25 days. Most common initial preoperative diagnosis was AA (84%). Most common position of the appendix during surgery was retrocecal (53.7%). HPE report revealed AA in 105 patients. Conclusion:USG abdomen is often falsely assuring, leading to unnecessary delay in effectively managing a patient of AA further leading to increased complications. Only the clinically equivocal cases require further radiological investigations where CECT abdomen is the preferred investigation, but it should be used judiciously.
RESUMO
Vermiform appendix should not be considered a vestigial organ in human beings but a lymphoid organ which when inflamed causes serious trouble. Acute appendicitis usually presents with pain and tenderness in the right iliac fossa associated with nausea and anorexia. It may have an atypical presentation depending on the position of the appendix. In post-ileal appendicitis, the pain is localized around the umbilicus and the shifting of pain may be absent. The ultrasound of abdomen may not be very helpful in this case, but the computed tomography scan of the abdomen may help reach the diagnosis. The delay in diagnosis and subsequent treatment of acute appendicitis may have catastrophic results.