Jainendra Kumar1, Akriti Komal2
BACKGROUND
Acute appendicitis (AA) is one of the commonest causes of acute abdominal
emergencies. Accurate diagnosis and earlier surgery is imperative in such cases.
Ultrasonography (US), and computed tomography (CT), are main stays accurate
diagnosis of this disease. This study was conducted to compare the accuracy of
US and CT in the diagnosis of AA and reduce number of negative appendectomies.
METHODS
This prospective study was done after approval from institutional ethical
committee and obtaining written consent. 164 patients with clinical features
suggestive of AA, were selected from emergency department of Patna Medical
College, Patna India during the period from January 2019 to December 2020. 98
were males and 66 females, mean age being 18.08 years. 142 patents (86.58 %)
underwent surgery, and 22 patients (13.41 %) were kept on clinical observation
in hospital after imaging. After detailed clinical workup and laboratory
investigations, all patients were subjected to both US and CT examination. Each
patient was reevaluated clinically, and a clinical correlation was done between both
sets of results. Based on these, final decision was made. Accuracy was decided
based on intra-operative findings in appendectomy group and were correlated with
imaging findings later with histopathologic findings.
RESULTS
Males outnumbered females, abdominal pain was present in 100%. The sensitivity,
specificity, positive predictive value, negative predictive value and overall accuracy
of US in diagnosis of AA in our study were 92.6 %, 76.4 %, 95.3%, 71.0% and
88.9 % respectively. The sensitivity, specificity, positive predictive value, negative
predictive value and overall accuracy of CT in diagnosis of AA were 99.1 %, 90.5
%, 98.6%, 87.8% and 97.8 % respectively.
CONCLUSIONS
US should be the first-line imaging modality as it is free from radiation. CT is
recommended as additional imaging tool to raise accuracy in diagnosis except in
pregnancy and selected pediatric patients.
