Evaluation of ultrasonography in the diagnosis of suspected acute appendicitis

ABSTRACT

To assess the efficacy of ultrasound [US] as a diagnostic modality to establish the indications for surgery in patients suspected for acute appendicitis with equivocal clinical pictures. Design: Prospective randomized study. Setting: Departments of Surgery and Radiology, Al-Jahra Hospital, Al-Jahra, Kuwait. Subjects: A total of 148 patients suspected to have acute appendicitis admitted with equivocal clinical findings in the period from October 1997 to November 1999. Abdominal US using the graded compression technique. A positive US was defined as a tender non-compressible appendix with an outer wall to outer wall diameter of >6mm. The sonographic data w e re correlated with clinical, operative and pathological findings. Graded compression US results were analyzed and showed 97.4% specificity, 88.2% sensitivity, 95.3% accuracy, 90.9% positive predictive value, and 96.5% negative predictive value. The results are discussed and compared to previous reports. US was found to be a useful tool in the diagnosis of suspected cases of acute appendicitis with equivocal clinical findings. US helped to minimize negative laparotomies and avoid unnecessary appendectomies. US is, however, an operator-dependent investigative tool