No abstract

Background: Acute appendicitis is a common and challenging disease. It represents one of the most common emergency surgical diseases encountered worldwide. It affects more than 250,000 people annually. It is globally rated as number one acute surgical emergency. The gold-standard for the diagnosis of acute appendicitis remains to be a properly taken history and a thoroughly conducted physical examination. However, recently Computed Tomography (CT) and Ultrasound Scan (USS) have been described as accurate diagnostic modalities in patients suspected to have acute appendicitis. Yet the role of CT scan in patients suspected to have acute appendicitis, but with equivocal clinical picture remains ill defined.Methods: This is a retrospective study conducted in King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia. The medical charts of patients who underwent an appendicectomy between first January 2010 and the end of February 2015 were reviewed for demographic data, clinical diagnosis, laboratory tests, imaging, and the type of surgery performed, the complications, and the ultimate outcome. The collected data was entered in a Case Review Form (CRF). The patients were divided in two groups (1 and 2) according to the final histopathology result. Group1 had a normal appendix and group 2 had acute appendicitis. The two groups were compared according to the above mentioned parameters.Results: Ninety patients were enrolled, 48 (53.3%) were males. Sixty six (73.3%) patients underwent laparoscopic appendicectomy and 24 (26.7%) patients underwent open appendicectomy. The histopathological diagnosis of acute appendicitis was made in 78 (86%) patients, and 12 (13%) patients had a normal appendix. The accuracy of the clinical diagnosis of acute appendicitis was 80%, while that of the CT scan and USS were 78% and 44%, respectively. Conclusion:In our study and other cited studies, a good clinical examination remains the gold standard for the diagnosis of acute appendicitis. It carries the highest sensitivity and the highest accuracy rate. USS, however, continues to be an important tool in the evaluation of acute gynecologic conditions, while CT scan is thought to be rapidly and confidently making an accurate diagnosis in equivocal cases.