No abstract

Purpose Accurate early diagnosis of appendicitis can decrease its complications and minimize the mortality, morbidity and costs. This prospective study evaluates the accuracy of bedside emergency physician performed ultrasound study diagnosis in acute appendicitis. Methods Patients who were suspicious to have appendicitis based on their clinical findings were included and underwent emergency physician performed ultrasound study. Then they were followed up until the recognition of final diagnosis based on pathology report or identification of an alternative diagnosis. Ultrasound studies were done by post-graduate year three emergency medicine residents or emergency medicine attending physicians who were attended in a 4 h didactic and practical course and with 7.5 MHz linear probe both in longitudinal and axial axes. Results Ninety-seven patients were included and analyzed. 27 (27.8 %) of patients had appendicitis according to the results of emergency physicians performed ultrasound studies. 19 (70.37 %) of them had appendicitis according to their pathologic reports too. Forty-three (44.3 %) of patients had appendicitis according to pathology reports. Only 19 (44.18 %) of them were diagnosed by emergency physicians. Emergency physician performed ultrasound study had a sensitivity of 44.18 %, specificity of 85.18 %, positive predictive value of 70.37 %, negative predictive value of 65.71 % and overall accuracy of 67.01 % in diagnosing appendicitis in patients clinically suspicious to have acute appendicitis. Conclusion Emergency physician performed bedside ultrasound has an acceptable overall accuracy but its sensitivity is low thus it can help emergency physicians to diagnose the acute appendicitis when used in conjunction with other clinical and para-clinical evaluations but not per se.Keywords Accuracy Á Emergency physician performed ultrasound Á Appendicitis Á Diagnosis Riassunto Scopo Un'accurata diagnosi precoce di appendicite può diminuirne le complicanze e ridurre al minimo mortalità, morbilità e costi. Questo studio prospettico valuta l'accuratezza della diagnosi ecografica, eseguita in emergenza da un medico, nello studio di appendicite acuta. Metodi Sono stati inclusi I pazienti con sospetto clinico di appendicite e sottoposti ad ecografia d'emergenza eseguita da un medico. I pazienti sono stati poi seguiti fino alla diagnosi definitiva, basata su reperti di anatomia patologia o su una diagnosi alternativa. Le ecografie sono state eseguite da residents di medicina con 3 anni post-laurea o da medici di medicina d'urgenza che avevano partecipato ad un corso didattico e pratico di 4 ore, con sonda lineare da 7.5 MHz sia con scansioni longitudinali che assiali. Risultati Sono stati inclusi ed esaminati novantasette pazienti. 27 (27,8 %) secondo i risultati delle ecografie effettuate dai medici di emergenza avevano un'appendicite. 19 (70.37 %) di loro avevano un'appendicite anche (2015( ) 18:57-62 DOI 10.1007 secondo i risultati dell 'anatomia patologica. 43 (44,3 %) pazienti avevano un'appendicit...