Role of Graded Compression Ultrasonography in Suspected Cases of Acute Appendicitis and its Surgical Correlation: A Prospective Study

  • Ritu Dhawan, Galhotra V, Gauba N, Gupta K
Keywords: Acute appendicitis, ultrasonography, positive predictive value, negative predictive value, sensitivity, specificity

Abstract

Aim: The aim of the study was to evaluate the role of Ultrasonography in suspected cases of acute appendicitis and its correlation with surgical findings.
Material and methods: Fifty patients over a period of 18 months who were suspected of acute appendicitis were studied and subjected to ultrasound examination. Those found positive on ultrasound were operated
and findings were compared with ultrasound reports. Sensitivity and specificity, PPV, NPV and accuracy was calculated.
Results: After comparing the findings the sensitivity was found to be 92.6%, specificity 100%, accuracy 94%, PPV 100% and NPV 75%. These values were then compared with various others studies.
Conclusion: Ultrasound is a safe, inexpensive, non invasive, quick to perform method for the diagnosis of acute appendicitis thereby, reducing the cost of treatment and preventing negative laparotomies.
Keywords: Acute appendicitis, ultrasonography, positive predictive value, negative predictive value, sensitivity, specificity

References

1. Abu Yousef MM, Phillips ME, Franken EA Jr, Al-Jurf AS, Smith WL. Sonography of acute appendicitis: A critical review. Critical Rev. in Diagnostic Imaging 1989;29(4):381-408.
2. Condon RE, Glysteen JJ, Raines AJH, Ritchie HD, Graham AD, Johnson HF. A sound approach to the diagnosis of acute appendicitis. The Lancet 1987; 1: 198-200
3. Abu Yousef MM, Bleicher JJ, Maher JW, Urdaneta LF, Franken EA Jr, Metcalf AM. High resolution sonography of acute appendicitis. Am J Radiol 1987; 149: 53-58.
4. Adams DH, Fine C, Brooks DC. High resolution real time ultrasonography: A new tool in the diagnosis of acute appendicitis. Am J Surg 1988; 155: 93-97.
5. Pearson RH. Ultrasonography for diagnosing appendicitis. BMJ 1988; 297: 309-310.
6. Terasawa T, Blackmore CC, Bent S, Kohlwes RJ. Systematic review: computed tomography and ultrasonography to detect acute appendicitis in adults and adolescents. Annals Int Medicine 2004; 141: 537-546.
7. Fa EM and Cronan JJ. Compression ultrasonography as an aid in the differential diagnosis of appendicitis. Surgery Gynae Obst 1989; 169: 290-298.
8. Skaane BP, Amland PF, Nordshus T and Solheim K. Ultrasonography in patients with suspected acute appendicitis: a prospective study. Br J of Radiology 1990; 63: 787-793.
9. Balthazar EJ, Birnabaum BA, Yee J, Meigibow AJ, Roshkow J, Gray C. Acute appendicitis: CT and US correlation in 100 patients. Radiology 1994; 190: 31-35.
10. Stephanie RW. The gastrointestinal tract. In : Rumack CM, Wilson SR, Charboneau JW, editors. Diagnosis Ultrasound. 3rd ed. China: Elsevier Mosby, 2005: 294-299.
11. Berry J, Malt RA. Appendicitis near its centenary. Ann Surg 1996; 200 (5): 567-575.
12. Puylaert JBCM. Acute appendicitis: US evaluation using graded compression. Radiology 1986; 158: 355-360.
13. Ramachandran P, Sivit CJ, Newman KD and Schwartz MZ. Ultrasonography as an adjunct in the diagnosis of acute appendicitis: A 4 year experience. J of Paed Surgery 1996; 31 (1): 164-169.
14. Schwerk WB, Wichtrus B, Rothmund M and Ruschoff J. Ultrasonography in the diagnosis of acute appendicitis: A prospective study. Gastroenterology 1989; 97: 630-639.
15. Puylaert JBCM, Rutgers PH, Lalisang RI, deVries BC, vanderWerf SDJ, Dorr JPJ et al. A prospective study of ultrasonography in the diagnosis of appendicitis. The New England Journal of Medicine 1987; 317: 666-669.
16. Jeffrey RB, Laing FC, Lewis FR. Acute appendicitis: High resolution real time US findings. Radiology 1987; 163: 11-14.
17. Karstrup S, Pedersen T and Roikjaer O. Ultrasonic visualisation of the inflamed appendix. BJR 1986; 59: 985-986.
18. Tauro LF, Premanand TS, Aithala PS, George C, Suresh HB, Acharya D, John P. Ultrasonography in acute appendicitis. Journal of Clinical and Diagnostic Research 2009; 3: 1731-1736.
19. Elahifar MNA, Taheri H, Bighamian A. Diagnostic value of ultrasound in patients suspected of acute appendicitis. Nepalese Journal of Radiology 2012; 2(2): 13-19
20. Chen SC, Wang HP, Hsu HY, Huang PM and Lin FY. Accuracy of ED sonography in the diagnosis of acute appendicitis. AJ of Em Medicine 2000; 18 (4): 449-452.
Published
2019-09-25
How to Cite
Ritu Dhawan, Galhotra V, Gauba N, Gupta K. (2019). Role of Graded Compression Ultrasonography in Suspected Cases of Acute Appendicitis and its Surgical Correlation: A Prospective Study. The Indian Practitioner, 67(5), 279-284. Retrieved from https://articles.theindianpractitioner.com/index.php/tip/article/view/824