Senthilnathan V, Gnanavelraja C, Alli Arimapamagan, Rajajeyakumar M
BACKGROUND Diagnosing appendicitis by Graded Compression Ultrasonogram is a difficult task because of limiting factors such as operator– dependent technique, retrocaecal location of the appendix and patient obesity. Posterior manual compression technique visualizes the appendix better in the Grey-scale Ultrasonogram. The Aim of this study is to determine the accuracy of ultrasound in detecting or excluding acute appendicitis and to evaluate the usefulness of the adjuvant use of posterior manual compression technique in visualization of the appendix and in the diagnosis of acute appendicitis MATERIALS AND METHODS This prospective study involved a total of 240 patients in all age groups and both sexes. All these patients underwent USG for suspected appendicitis. Ultrasonography was performed with transverse and longitudinal graded compression sonography. If the appendix is not visualized on graded compression sonography, posterior manual compression technique was used to further improve the detection of appendix. RESULTS The vermiform appendix was visualized in 185 patients (77.1%) out of 240 patients with graded compression alone. 55 out of 240 patients whose appendix could not be visualized by graded compression alone were subjected to both graded followed by posterior manual compression technique among that Appendix was visualized in 43 patients on posterior manual compression technique amounting to 78.2% of cases, Appendix could not be visualized in the remaining 12 patients (21.8%) out of 55. CONCLUSION Combined method of graded compression with posterior manual compression technique is better than the graded compression technique alone in diagnostic accuracy and detection rate of the vermiform appendix.
