Ultrasonography

Abstract

Acute appendicitis is a diagnostic dilemma in young female patients. Ultrasonography has an important role in making preoperative diagnosis and ruling out other gynecological pathologies in women. Objectives: (1) To determine the diagnostic accuracy of ultrasonography for acute appendicitis. (2) To compare it with impression, in female patients. Design: Cross-sectional comparative study. Setting: Female Surgical department. Combined Hospital, Rawalpindi. Period: Mar 2006 - Jun 2008. Patients and Methods: 214 consecutive female patients presenting with pain right lower abdomen were enrolled. The patients were assessed clinically. Blood complete picture and urine analysis was carried out in all patients. Ultrasonography was performed by radiologist with 7.5 MMz short-focused high-resolution probes. Patients were operated upon and appendicectomy was done. Specimens were sent for histopathology to confirm appendicitis. Results: Ultrasound supported the diagnosis of acute appendicitis in 163 (76.2%) patients. In ultrasound with positive findings, patients 161 (98.8%) had inflamed appendices on histopathology and 2 (1.2%) had normal appendices. The over all sensitivity of ultrasonography was 81.3% and specificity was 87.5%. Diagnostic accuracy of ultrasonography was 81.8%. The over all sensitivity of surgeon’s clinical impression remained81.8% and specificity was 62.5%. Diagnostic accuracy of ultrasonography was 81.8%. Conclusions: Ultrasound should be the initial diagnostic modality in females presenting with right lower abdominal pain. It is highly specific, effectively rules out other pathologies and helps in minimizing the avoidable surgical trauma.