Ultrasound Examination for the Diagnosis of Acute Appendicitis
CENTRAL ASIAN JOURNAL OF MEDICAL AND NATURAL SCIENCES, (2022)Abstract
Objective: to determine the usefulness and accuracy of ultrasound for the diagnosis of acute appendicitis.
Methods. This retrospective study included 242 of 286 patients who underwent 2021 appendix ultrasound. The ultrasound report, pathology report, and clinical records were reviewed. The pathology report has been used as the gold standard for diagnosing acute appendicitis.
Results: The overall rate of visualization of the appendix was 41.7%. Fifty-six patients (23%) had a positive diagnosis of acute appendicitis on ultrasound, 45 (19%) had a negative diagnosis, and 141 (58%) had an inconclusive diagnosis; 17 patients (7%) had an alternative diagnosis suggested by ultrasound. Twenty-nine patients (12%) underwent a CT scan based on the ultrasound report, 6 of whom had a positive diagnosis of acute appendicitis, 5 had a negative diagnosis, and 18 had an alternative diagnosis suggested by the CT scan. Sensitivity, specificity, positive predictive value, and negative predictive value of US for acute appendicitis were 75.9%, 89.7%, 73.2%, and 91.0%, respectively, after adjusted calculation for the US inconclusive group.
Conclusions. The results of ultrasonography of acute appendicitis at the Queen Elizabeth Hospital in Hong Kong are comparable to those reported in the literature. Ultrasonography is a useful and safe imaging modality for the investigation of acute appendicitis, and computed tomography has an additional role in the diagnosis of acute appendicitis and the management of patients with right lower quadrant pain.