DIAGNOSTIC ACCURACY IN ACUTE APPENDICITIS: COMPARISON BETWEEN CLINICAL IMPRESSION AND ULTRASOUND FINDINGS
Abstract
A cross-sectional study to determine the diagnostic accuracy of clinical impression and graded compression abdominal ultrasonography in acute appendicitis used individually or complementary to each other was conducted in a busy surgical unit. Eighty-nine cases subjected to categorized clinical impression and ultrasonography preoperatively achieved fairly high sensitivity (84.3% and 81.81% respectively) but low specificity (23.68% and 38.23%) with an overall negative predictive value of 31%, implying it to be a poor indicator to avoid negative appendectomies.References
Jess I. Acute appendicitis: epidemiology, diagnostic
accuracy and complications. Scand J Gastroenterology,
; 18: 161-3.
Rehman SJ. Review of acute appendicitis at civil
hospital, Abbottabad. JPMA, 1983; 35 (10): 298-300.
Rathore AH. Ultrasonography in acute appendicitis.
The Professional, 1995; 02 (02): 131-134.
Mufti T. Survey of major surgical operations in Hazara
Division. JAMC, 1989; 2(1): 6-10.
Gilmore OJA, Browett JP, Griffin PH, et al.
Appendicitis and mimicking conditions. Lancet, 1975;
ii: 421-4.
deDombal FT, Leaper DJ, Horrocks J, Staniland JR &
McCann A. Human and computer aided diagnosis of
abdominal pain: further report with emphasis on
performance of clinicians. BMJ, 1974; i: 376-80.
Scarlett PY, Cooke MW, Clarke D, Bates C & Chan M.
Computer aided diagnosis of acute abdominal pain at
Middle Borough General Hospital. Ann R Coll Surg
Engl, 1986; 68: 179-81.
Nauta RJ & Magnant C. Observation versus operation
for abdominal pain in the right lower quadrant. Am J
Surg, 1986; 151: 746-8.
Marchand A, Van Lente F & Galen RS. The assessment
of laboratory tests in the diagnosis of acute
appendicitis. Am J Clin Pathol, 1983; 80: 369-74.
Nordback I & Harju E. Inflammation parameters in the
diagnosis of acute appendicitis. Acta Chir Scand, 1988;
: 855-9.
Clifford PC, Chan M & Hewett DJ. The acute
abdomen: management with microcomputer aid. Ann R
Coll Surg Engl, 1986; 68: 182-4.
Lua YM. Negative findings at appendicectomies. Am J
Surg, 1984; 148: 375-378.
Schirmer BD. Laparoscopic versus traditional
appendicectomies for suspected appendicitis. Am J
Surg, 1993; 165(6): 670-5.
Kum CK. The diagnostic laparoscopy: reducing the
number of normal appendicectomies. Dis Colon
Rectum, 1993; 36(8): 763-6.
Grunewald B. Should the normal appendix be removed
at operation for appendicitis. J R Coll Surg Edinb,
; 38(3): 158-60.
Bilby JH, Gibney RG & Cooperberg PL.
Ultrasonography in acute appendicitis. J Canadian
Radiol, 1989; 40: 22-24.
Gaensler EHL, Jeffery JRRB, Liag FC, et al.
Sonography in patients with suspected acute
appendicitis: Value in establishing alternative
diagnosis. Am J Roentgenol, 1989; 152: 49- 51.
Kang WM, Lee CH, Chou YH, et al. A clinical
evaluation of ultrasonography in the diagnosis of acute
appendicitis. Surgery, 1989; 105: 154-59.
Fa EM & Cronan JJ. Compression ultrasonography as
an aid in the differential diagnosis of appendicitis. Surg
Gynaecol Obstet, 1989; 169: 290-97.
Schwerk WB, Wicktrup B & Rothmund M.
Ultrasonography in the diagnosis of acute appendicitis:
A Prospective study. Gastroenterology, 1989; 97: 630-
Ooms HWA, Koumans RKJ, Kang YPJH, et al.
Ultrasonography in the diagnosis of acute appendicitis.
Br J Surg, 1991; 78: 315-18.
Julien BCM & Puylaert MD. A prospective study of
ultrasonography in the diagnosis of appendicitis. N
Engl J Med, 1987; 317: 666-9.
Raymord MA. How to reduce the number of negative
appendicectomies: A prospective two- centre study of
patients? Helr Chir Acta, 1994; 60(4): 647-51.
