Investigating Diagnostic Value of Ultrasonography in Acute Appendicitis

Hosseini, Asieh; Omidian, Javad; Nazarzadeh, Reza

doi:10.4103/abr.abr_79_18

Cited by 13 publications

(8 citation statements)

References 12 publications

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“…[15] Although USG has been shown to have more than 70% sensitivity and specificity in the diagnosis of acute appendicitis, and it has been shown to have high diagnostic accuracy in acute appendicitis, the method depends largely on the user's experience and knowledge. [16][17][18] In the study conducted by Hosseini et al, [19] the sensitivity and specificity of USG were reported as 37.1% and 87.2%, respectively, in tertiary health care centers. Due to its low negative predictive value (11.7%), USG was recommended for differential diagnosis and complicated cases of appendicitis rather than routine use.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Ultrasonography and Scoring Systems: The Effect on the Negative Appendectomy Rate and Gender

Şenocak

Kaymak

2020

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Despite the development of clinical, laboratory, and imaging methods, the diagnosis of acute appendicitis is not always easy, and negative appendectomy rates are still high. This study aims to reveal the effects of different scoring systems on the diagnostic accuracy of acute appendicitis and negative appendectomy rates, alone or when evaluated together with ultrasonography. METHODS: In this study, 202 consecutive patients who underwent emergency appendectomy for acute appendicitis were included. Clinical scores of all patients were preoperatively calculated using Ohmann, Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA), Lintula, Eskelinen, and Alvarado scoring systems. Abdominal ultrasonography (USG) was performed randomly in all cases. The sensitivity and specificity of scoring systems were calculated according to the threshold values. The area under the curve (AUC) was calculated using ROC analysis. In the regression model, histological diagnosis of appendicitis was used as the dependent variable, while scoring systems and USG were preferred as independent variables. RESULTS: The negative appendectomy rate was 15.8%. In the diagnosis of acute appendicitis, Ohmann was the most predictive for both genders (DOR=24.2, 95% CI 6.98-84.44). Similarly, the lowest negative appendectomy rates were obtained with the Ohmann score as 6.9% in females and 3.4% in males. When the scores were combined with USG, the rate of diagnostic accuracy for acute appendicitis was not increased. However, when Ohmann and USG were combined, negative appendectomy rates were further reduced for women from 6.9% to 4%. CONCLUSION: In addition to being a good diagnostic predictor of acute appendicitis in male and female patients, Ohmann score provides the best negative appendectomy rates. The combination of USG and scoring systems does not increase the diagnostic accuracy of acute appendicitis. However, negative appendectomy rates are significantly reduced when the USG and Ohmann scale are used together in females, while this reduction is minimal in men.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Ultrasonography and Scoring Systems: The Effect on the Negative Appendectomy Rate and Gender

Şenocak

Kaymak

2020

Ulus Travma Acil Cerrahi Derg

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“…In many prospective studies, the graded compression scanning technique has been recognized as the standard scanning technique of the appendix, with a sensitivity of 77-89%, and a specificity of 94-96% [6,13,[28][29][30][31]. This technique can be used in combination with the "mowingthe-lawn" technique using a 3.5 MHz convex probe to scan the whole abdomen, or it can be used alone, usually The "mowing-the-lawn" technique.…”

Section: Graded Compression Techniquementioning

confidence: 99%

Overview of the ultrasonography techniques in the diagnosis of appendicitis – elaboration of a novel anatomy scanning method

Miao

Zhang

et al. 2020

Med Ultrason

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This article aims to introduce a novel anatomical scanning method which requires scanning according to varied anatomic positions of the appendix based on the widely used graded compression method. We suggest placing the probe longitudinally in the region of the terminal cecum and moving it laterally to explore the sub-cecal appendix. The probe should be placed transversely on the medial side of the cecum to explore the pre-ileal appendix or post-ileal appendix. Placing the probe perpendicularly along external iliac vessels can help explore the pelvic appendix. The probe should be placed transversely on the paracolic sulci, and moved along the paracolic sulci to observe the extra-peritoneal appendix. Using the cephalic end of the probe as a pivot, push and squeeze the cecum to make it move bilaterally as much as possible, in order to expose the retrocecal appendix behind the air-filled cecum. It is our belief that this anatomical scanning method will greatly improve appendix detection rate and diagnostic accuracy, and provide guidance for surgical localization.

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“…In most of the cases, it is difficult to reach a definitive diagnosis. Many patients do not show the classical signs and symptoms of acute appendicitis 7 . Various other conditions result in right iliac fossa pain, especially in females, which may complicate further the process of diagnosis 1 .…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy Of Hyperbilirubinemia In Acute Appendicitis

Baseer,

Rehman,

Kalwar

et al. 2023

JRMC

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Objective: To determine the diagnostic accuracy of serum Bilirubin in cases of acute appendicitis keeping the histopathological findings as Gold standard. Study Design: Cross sectional validation study. Place and Duration of the Study: Surgical Unit, Sheikh Khalifa Bin Zayed Al-Nayhan Hospital (Combined Military Hospital), Rawalakot, Azad Kashmir, from Jan 2022 to June 2022. Methodology: A total of 380 patients aged between 18 to 65 years, who matched the inclusion and exclusion criteria suspected of acute appendicitis were included. Serum Bilirubin level was noted. Appendectomy was done. Specimen of appendix was sent for histopathology for confirmation of the diagnosis. Results: In our study, mean age of the patients was 34.015 with a standard deviation of 13.32. 65% (n=247) of the patients were males and 35% (n=133) were females. Frequency of acute appendicitis on histopathology was 82.89% (n=315) while 17.1% (n=65) had no findings of the disease. Validity of serum Bilirubin in diagnosing appendicitis using histopathology showed 57.36% (n=218) were true positive, 2.1% (n=8) were false positive, 15% (n=57) were true negative and 25.52 %( n=97) were false negative. Specificity, sensitivity, negative predictive value, positive predictive value, accuracy rate, positive likelihood ratio and negative likelihood ratio were 87.69%, 69.20%, 37.01%, 96.46%, 72.36%, 5.62 and 0.35 respectively. Conclusion: Serum Bilirubin is a useful marker for diagnosing the acute appendicitis and can be used as a good alternative diagnostic modality in suspected cases of acute appendicitis.

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Investigating Diagnostic Value of Ultrasonography in Acute Appendicitis

Cited by 13 publications

References 12 publications

Diagnostic Accuracy of Ultrasonography and Scoring Systems: The Effect on the Negative Appendectomy Rate and Gender

Diagnostic Accuracy of Ultrasonography and Scoring Systems: The Effect on the Negative Appendectomy Rate and Gender

Overview of the ultrasonography techniques in the diagnosis of appendicitis – elaboration of a novel anatomy scanning method

Diagnostic Accuracy Of Hyperbilirubinemia In Acute Appendicitis

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