The Sensitivity and Specificity of the Conventional Symptoms and Signs in Making a Diagnosis of Acute Appendicitis

ABSTRACT

Introduction: Simple appendicitis can progress to perforation; which is associated with a much higher morbidity and mortality. So; surgeons have therefore been inclined to operate when the diagnosis is probable rather than wait until it is certain. Objective: This study is designed to evaluate the sensitivity and specificity of clinical examination in the diagnosis of acute appendicitis.Methods: The study included 866 patients of acute appendicitis who had undergone appendicectomy with preoperative diagnosis of acute appendicitis. They were analyzed retrospectively. The parameters evaluated were age/gender; clinical presentation (signs and symptoms) and total white blood cell counts. The operative findings were recorded and the inflammation of the appendix was graded into normal; acutely inflamed and gangrenous. Results: Clinical diagnosis was made correctly in 807 (93.2) of the patients. White blood cells count ranged from 3.70 to 45.30 /mm3 (mean 17.5353 /mm3). It was 10;000/mm3 in 133 (15.4) patients.Conclusions: Clinical assessment is the best criterion to reach a confident diagnosis. Investigations may supplement the diagnosis but are never a substitute for it