Accuracy of Ultrasonography in Diagnosing Acute Appendicitis

Abstract

Introduction: Appendicitis is inflammation of the appendix, a small, tubular organ in the right lower abdomen that is attached to the large intestine. Aim: To evaluate the accuracy of sonography in diagnosing acute appendicitis in patients with Alvarado score 4–7. Methods: This is a retrospective cross-sectional study. Setting: this study performed in Al-Emam Al-Sadeq Teaching hospital during a one-year period from 1/2023 to 1/2024. Sample: Patients with Alvarado score 4-7 and divided them in two groups: those with Ultrasound study prior to surgery (group A) and those without any imaging modalities for diagnosis of AA (group B). The demographic information, histopathology, physical examination, laboratory data, sonography report and histopathological reports of patients were gathered. Results: A total of 100 patients had Alvarado scores 4-7 including 58 males and 42 females. 50 patients did not have any imaging and 50 had undergone sonography before operation. Ultrasound had overall sensitivity of 62 %, specificity 80 %, PPV 88 %, NPV 48% and accuracy of 69 %. Negative appendectomy rate was 12 % in group A and 48 % in those group B, with a higher rate in females. Conclusion: Ultrasound is more useful when the patient is female, and has 78.9% specificity; however, it is not reliable when the result is negative and maybe other accessory modalities such as CT scan are required for a more accurate diagnosis. Recommendations: Modified Alvarado score” plus ultrasound as a method of choice for diagnosing appendicitis. Modified Alvarado score is the Alvarado score missing the shift of left of leukocytes, Health education program about early detection of appendicitis and Ongoing research about Ultrasonography in Diagnosing Acute Appendicitis