ROLE OF ULTRASOUND IN ACUTE APPENDICITIS
AbstractBackground: Misdiagnosis of acute appendicitis is a common and crucial problem in generalsurgery. Graded compression ultrasonography is one of the new diagnostic technique that isreported to have improve the diagnostic accuracy and clinical outcome. The aim of current study isto assess the role of this diagnostic modality in the management of acute appendicitis. Methods:This is a cohort observational study comparing the adverse outcome in two different groups ofpatients admitted with suspected acute appendicitis at two different hospitals in two differentcountries. The first group of 200 patients at Ayub Teaching Hospital Abbottabad, Pakistan, wasmanaged without preoperative ultrasonography. In the second group of 200 patients admitted atNajran General Hospital Najran Saudi Arabia, graded compression abdominal ultrasonographywas routinely performed preoperatively. Diagnostic accuracy of the protocol in each group wasmeasured statistically and rates of negative appendicectomy and perforation were determined.Results: Addition of routine ultrasonography in clinical assessment for acute appendicitisdecreases the sensitivity but significantly increases the specificity of the protocol thereby reducingthe false positive rate translating into decreased negative appendicectomy rate. Rate of negativeappendicectomy was 22.5% in group one and 4.7% in group two.Perforation rate was 15.6% ingroup 1 and 15% in group two. Conclusion: Proper clinical assessment is the mainstay ofdiagnosis in acute appendicitis and addition of routine ultrasound by graded compressiontechnique can improve the diagnostic accuracy and adverse outcome.Key Words : Acute Appendicitis, Ultrasonography, Diagnosis,
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