Accuracy of Ultrasound in the Diagnosis of Acute Appendicitis and Correlation with Histopathology

Shrestha, Anil; Khadka, Hensan; Poudel, Baburam; Basnet, Robin Bahadur; Basnet, Sijan

doi:10.3126/njr.v8i2.22975

Cited by 3 publications

(4 citation statements)

References 14 publications

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“…This study revealed that appendicitis mostly occurred at the children's age. It is in line with the results of other studies showing that the incidence of Appendicitis mainly occurred in the children's period ranging from 10 to 18 years old (9).…”

Section: Discussionsupporting

confidence: 92%

“…Ultrasonography is one of the imaging modalities of the last decade widely used with a variety of considerations that ultrasound is an accessible, mobile, noninvasive, and relatively inexpensive examination. Although it is known that ultrasound has lower sensitivity and specificity values than CT-Scan, this tool is preferred as it has several advantages, as mentioned previously (6)(7)(8)(9). Several studies that have been carried out show the results of ultrasound diagnostic tests as a diagnostic modality for acute appendicitis, which has values that vary from low to high, namely sensitivity and specificity of 60-95%.…”

Section: Introductionmentioning

confidence: 99%

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The Evaluation of the Sensitivity and Specificity of Ultrasound Examination in Patients With Suspected Acute Appendicitis

Majdawati¹,

Sarı²

2021

Advances in Health Sciences Research

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Background: Acute Appendicitis is inflammation of the appendix, which manifests as pain in the lower right abdomen that can develop into an acute abdomen. This situation can end in the emergency room and require immediate surgical treatment. Ultrasound is the initial choice most often used for the diagnosis of Appendicitis as well as determining whether surgery is needed. Objective: To identify the sensitivity and specificity of ultrasound as an imaging modality for the diagnosis of Acute Appendicitis at PKU Muhammadiyah Gamping Hospital in Yogyakarta. The results of this diagnostic test are essential to be used as an evaluation of the radiology skills, the ultrasound modalities used in health services, as well as being useful for improvement. Method: This research study is a diagnostic test of ultrasound of suspected Acute Appendicitis with a gold standard. The result emerged from the histopathological tissue from the appendectomy. The research subjects consisted of 72 suspected Appendicitis subjected to ultrasound and continued with appendectomy and histopathological in 2014 -2017. The sensitivity and specificity values of the ultrasound were calculated, which were useful for evaluating diagnostic services at PKU Muhammadiyah Gamping Hospital, Yogyakarta. Results: The number of study subjects was 72, with positive ultrasound results of 52 and a negative ultrasound of 20 samples. The 52 respondents with positive ultrasound consisted of 25 adults and 47 children dominated by males. Twenty samples with negative ultrasound results consisted of 9 adults and 11 children dominated by females. The results of sensitivity and specificity values of ultrasound were 82.7%, 33.33%, and 53% of accuracy. The results of this value can be used as an evaluation of ultrasound in cases of Acute Appendicitis in PKU Muhammadiyah Gamping, Hospital, Yogyakarta in Indonesia. Conclusion: Ultrasound has a good sensitivity value for the diagnosis of Acute Appendicitis. However, it has a low specificity value. It shows that the ultrasound can be used as a modality for diagnosing Acute Appendicitis, which has a role in screening the diagnosis. Ultrasound cannot be used as a screening for suspected patients with Acute Appendicitis who are entirely normal or in good condition. It will be the researchers' evaluation of the cause of the low specificity value to improve the diagnosis of suspected Appendicitis.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

The Evaluation of the Sensitivity and Specificity of Ultrasound Examination in Patients With Suspected Acute Appendicitis

Majdawati¹,

Sarı²

2021

Advances in Health Sciences Research

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“…HPE study showed AA in 58 out of 64 cases (90.6 %) who were diagnosed with AA on USG. Shreshtha et al found USG to have a sensitivity of 85.7% and specificity of 88.2% in the diagnosis of AA with PPV of 96.4% and NPV of 62.5%( 16 ). Inamdar et al found the accuracy and sensitivity of USG in the diagnosis of AA to be 95% and 95.83% ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

The Roles of USG and NCCT in the Diagnosis of Acute Appendicitis: A Study in a Tertiary Care Center in North Eastern India

Uddalok Das,

Amarendra Nath Sarkar,

Dilip Chandra Barman

et al. 2023

Ethiop J Health Sci

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BACKGROUND: Acute appendicitis is a common cause of hospital admission and emergency laparotomy among children and young adults. Although the diagnosis is clinical, the use of radiological imaging has emerged over the past decades. Its principal use is as a problem-solving tool in equivocal cases. Owing to the increased use of imaging in the last few years, the negative appendicectomy rate has dropped significantly. In this prospective observational study, we compared the diagnostic accuracy of Ultrasonography and Non-Contrast Computed Tomography. METHOD: One hundred and eighteen patients with clinically suspected appendicitis followed a designed protocol. Patients underwent appendicectomy after a first performed positive ultrasonography or after a positive Non-Contrast Computed Tomography when Ultrasonography was equivocal or nonspecific. When any other diagnosis was apparent in either imaging modality which could explain the symptomatology in the patient, they were considered negative for acute appendicitis and treated accordingly. RESULTS: The respective sensitivity, specificity, and accuracy for Ultrasonography, Non-Contrast Computed Tomography, and the whole diagnostic pathway for the diagnosis of acute appendicitis were 70.73%,80.83%, and 78.54; 100%,100%,100%, and 83.6%; and 100%,83.33% and 94.92%. CONCLUSION: Using Ultrasonography as the first-line diagnostic tool and Non-Contrast Computed Tomography as a complementary second-line diagnostic tool, appendicitis can be diagnosed with high accuracy and the negative laparotomy rate can be brought down significantly without any increase in the risk of complications. Computed Tomography is superior to Ultrasonography for the diagnosis of acute appendicitis.

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“…Although similar visibility rates are reported for acute appendicitis patients, the lower deviation in diameter in ulcerative appendicitis may challenge the feasibility of visualising the appendix. 37 Still, identifying potential characteristics that predict treatment response would enable a patient‐tailored treatment approach for UC patients in the ever‐increasing treatment armamentarium.…”

Section: Discussionmentioning

confidence: 99%

Intestinal ultrasound detects an increased diameter and submucosal layer thickness in the appendix of patients with ulcerative colitis compared to healthy controls – a prospective cohort study

Reijntjes

Voogd

Bemelman

et al. 2022

Aliment Pharmacol Ther

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Summary Background Increasing evidence suggests that appendicectomy as alternative treatment for ulcerative colitis (UC), especially in patients with histopathological appendiceal inflammation. Intestinal ultrasound (IUS) is a non‐invasive diagnostic modality to characterise appendiceal inflammation. Aims To assess appendiceal IUS characteristics in UC patients and compare findings to healthy controls (HC). Methods In this prospective study, appendiceal IUS was performed in consecutive UC patients with active (A; n = 35) or quiescent (Q; n = 30) disease and in HC (n = 30). Transverse appendiceal diameter (TAD) and additional IUS parameters (bowel wall thickness, submucosal layer thickness and colour Doppler signal) were assessed. Results The appendix was visualised in 41/65 UC patients (63.1%; A vs. Q: 23/35 vs. 18/30, p = 0.67) and 18/30 (60%) HC. UC patients had a higher TAD (A: 5.5 mm, Q: 5.0 mm, HC: 4.3 mm; A‐HC p < 0.01; Q‐HC p = 0.01, A‐Q p = ns) and submucosal layer thickness (A: 1.0 mm, Q: 1.0 mm, HC: 0.7 mm; A‐HC p < 0.01, Q‐HC: p = 0.01, A‐Q: p = ns) when compared to HC. A TAD ≥6 mm corresponding to an ultrasonographic suspicion of acute appendicitis was mainly reported in A‐UC patients (A: 43%; Q: 6%; HC: 0%, p = 0.01) and occurred irrespective of disease extent. However, none of the patients had a clinical suspicion of acute appendicitis. Conclusion A TAD ≥6 mm was predominantly seen in A‐UC. TAD was higher in UC patients compared to HC irrespective of disease activity and was characterised by an increased submucosal layer thickness. IUS therefore has the potential to identify UC patients with appendiceal inflammation.

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Accuracy of Ultrasound in the Diagnosis of Acute Appendicitis and Correlation with Histopathology

Cited by 3 publications

References 14 publications

The Evaluation of the Sensitivity and Specificity of Ultrasound Examination in Patients With Suspected Acute Appendicitis

The Evaluation of the Sensitivity and Specificity of Ultrasound Examination in Patients With Suspected Acute Appendicitis

The Roles of USG and NCCT in the Diagnosis of Acute Appendicitis: A Study in a Tertiary Care Center in North Eastern India

Intestinal ultrasound detects an increased diameter and submucosal layer thickness in the appendix of patients with ulcerative colitis compared to healthy controls – a prospective cohort study

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