Evaluation of suspected clinical cases of acute appendicitis: a prospective study of 72 patients

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