Ultrasonography in Patients with Suspected Acute Appendicitis

Debnath, Jyotindu; Ram, Sree; Balani, Sharda; Chakraborty, Ipsita; Gupta, Phalguni; Bindal, RK; Sengupta, Partha Pratim

doi:10.1016/s0377-1237(05)80166-2

Cited by 7 publications

(5 citation statements)

References 12 publications

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“…The sensitivity, specificity and diagnostic accuracy of our study was comparable with other studies. 20 The visualization rate was found to be higher in males (65.62%) than in females (34.38%).…”

Section: Ultrasonographymentioning

confidence: 87%

A Clinicopathological Study to Establish the Correctness of the Diagnosis of Acute Appendicitis in Cases of Acute Right Lower Quadrant Pain of Abdomen

Patnaik¹,

Acharya²,

Sunkara³

et al. 2019

jemds

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BACKGROUNDAcute appendicitis is a common surgical condition that requires prompt diagnosis in order to minimize morbidity and avoid serious complications. Accurate identification of patients who require immediate surgery as opposed to those who will get benefit from active observation is not always easy. 1 Therefore, several scoring systems have been devised to aid decision making in doubtful cases, including Ohmann, Alvarado, Eskelinen and several others. These scores utilize routine clinical and laboratory assessment, thus being simple to use in a variety of clinical settings. We wanted to study the various clinical presentations of patients with suspected acute appendicitis, evaluate diagnostic accuracy of modified Alvarado score and Ohmann score in corelation to histopathology report for diagnosis of acute appendicitis. To determine the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of the individual scoring systems and ultrasonography and the same parameters when they are combined together. METHODSThe present descriptive study was undertaken at Hi Tech Medical College, Bhubaneswar, Odisha. During the period of October 2016 to November 2018. After thorough clinical examination and routine blood investigation, every patient was allotted modified Alvarado score and Ohmann score. Ultrasonography, intraoperative findings, histopathological examination were done. Sample size was taken for convenience. RESULTSUS had a sensitivity of 90.32%, specificity 80.95%, PPV 87.5%, NPV 85% and diagnostic accuracy of 86.54%. Alvarado score gives sensitivity 90.32%, specificity 61.90%, PPV 77.78%, NPV 81.25% and diagnostic accuracy of 78.85%. Ohmann score yields sensitivity 80.65%, specificity 80.95%, PPV 86.21%, NPV 73.91% and diagnostic accuracy of 80.77%. When modified Alvarado score combined with ultrasonographic finding then sensitivity, specificity, PPV, NPV and diagnostic accuracy increases to 96.3%, 100%, 100%, 90% and 97.22% respectively. When Ohmann score also combined with ultrasonographic findings sensitivity, specificity, PPV, NPV and diagnostic accuracy increases to 92.31%, 88.24%, 92.31%, 88.24% and 90.69% respectively. CONCLUSIONSWhen any of the two scoring systems i.e. modified Alvarado score and Ohmann score was used along with US, it increased the sensitivity, specificity, PPV, NPV, diagnostic accuracy and reduced the negative appendectomy rates. So, combination of scoring system with ultrasonography is very helpful to correctly diagnose acute appendicitis.

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Section: Ultrasonographymentioning

confidence: 87%

A Clinicopathological Study to Establish the Correctness of the Diagnosis of Acute Appendicitis in Cases of Acute Right Lower Quadrant Pain of Abdomen

Patnaik¹,

Acharya²,

Sunkara³

et al. 2019

jemds

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“…As calculated by our study, the sensitivity of USG was 90.32%, specificity 80.95%, PPV 87.5%, NPV 85% and Diagnostic accuracy of 86.54% which has been comparable with the other studies in the previous literature. 22 When modified Alvarado score and ultrasonography were compared in terms of sensitivity, specificity, positive predictive value, diagnostic accuracy and false-negative cases, the results are almost same. Neither one is significantly advantageous.…”

Section: Ultrasonography Analysismentioning

confidence: 89%

A clinicopathology study to establish the accuracy of diagnosis of acute appendicitis in case of acute right lower quadrant pain of abdomen

2017

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Background: Acute appendicitis, one of the most common surgical emergency is also one of the most challenging surgical dilemma for every surgeon, both in diagnosis and treatment. A negative exploration on one hand has to be weighed against the risk of subsequent perforation during expectant management especially in doubtful cases. We conducted a study to find out if diagnosis by scoring systems and graded ultrasonography improves clinical outcomes for patients with suspected appendicitis.Methods: It was a prospective and observational study including 52 patients of clinically suspected acute appendicitis presenting in the surgical emergency. All patients underwent clinical scoring using Alvarado scores and Ohmann’s score and Ultrasonography. Later, based on the intra operative findings and histopathological diagnosis of acute appendicitis, the sensitivity, specificity, positive predictive value and negative predictive value were calculated individually and by combining the scoring systems and imaging together.Results: The sensitivity, specificity, PPV and NPV of ultrasonography when combined with scoring systems (both Alvarado and Ohmann’s) is increased significantly as compared to when used individually for diagnosis of acute appendicitis. As calculated by our study, the sensitivity of USG was 90.32%, specificity 80.95%, PPV 87.5%, NPV 85% and diagnostic accuracy of 86.54% which has been comparable with the other studies in the previous literature.Conclusions: Combination of scoring systems with Ultrasonography leads to the prompt diagnosis and early treatment of many cases of appendicitis. Hence, improving clinical outcomes in doubtful cases.

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“…With its comprehensive inclusion of clinical parameters and imaging results, the Yash scoring system has been advocated for its potential to enhance diagnostic accuracy. 2 In contrast, the Fenyo-Lindberg scoring system focuses on clinical features, prioritizing simplicity in its approach. 6 This study's intention to compare these two scoring systems aligns with the need for evidence-based approaches to acute appendicitis diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…A study by Yash et al demonstrated the utility of their scoring system in a specific population. 2 The comparative aspect of our research will offer a broader perspective, potentially identifying nuances in diagnostic performance across diverse patient groups.…”

Section: Discussionmentioning

confidence: 99%

“…The Yash scoring system incorporates multiple clinical parameters, including migration of pain, nausea, and vomiting, anorexia, tenderness in the right iliac fossa, rebound tenderness, hyperesthesia in Sherren's triangle, fever, elevated white blood cell count, and C-reactive protein levels, as well as ultrasonography results. 2 On the other hand, the Fenyo-Lindberg scoring system encompasses components such as total leukocyte count, duration of pain, progression of pain, aggravation of pain by coughing, vomiting, migration of pain, rebound tenderness, rigidity of abdominal wall, and tenderness outside of the right lower quadrant. 3 A critical evaluation comparing the diagnostic accuracy of these two scoring systems is imperative to inform clinical practice and enhance the precision of acute appendicitis diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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A prospective observational comparative study to compare the diagnostic efficacy of the Fenyo Lindberg scoring system and Yash scoring system in patients of acute appendicitis in tertiary care hospitals in central India

Srinivasa Reddy,

Tote

2024

F1000Res

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Background Acute appendicitis is a typical surgical emergency requiring prompt and accurate diagnosis for timely intervention. This prospective observational comparative study aims to assess the diagnostic efficacy of two scoring systems, the Yash scoring system and the Fenyo-Lindberg scoring system, compared to the gold standard of histopathological diagnosis. The study is conducted at A.V.B.R.H., a tertiary care hospital in Central India, focusing on providing valuable insights into the comparative performance of these scoring systems in the local patient population. Methods The study adopts a prospective observational comparative design, enrolling clinically diagnosed cases of acute appendicitis from the outpatient and inpatient departments of the Surgery department at A.V.B.R.H. Patients willing to undergo surgery are included. At the same time, those with complicating factors or contraindications are excluded. Data collection involves thorough clinical evaluations, scoring system assessments, and comprehensive investigations, with histopathology as the reference standard. Statistical analyses include descriptive statistics, comparative analyses, primary outcome assessments, and regression analyses, ensuring a robust evaluation of the diagnostic efficacy of the scoring systems. Expected Outcome Anticipated outcomes include a comprehensive understanding of the diagnostic efficacy of the Yash and Fenyo-Lindberg scoring systems in acute appendicitis. The study aims to identify which scoring system demonstrates superior accuracy, sensitivity, and specificity, providing valuable information for clinical decision-making. The results will contribute to optimizing diagnostic protocols for acute appendicitis, potentially influencing patient management and surgical interventions. This study’s findings are expected to be relevant to the local setting and broader contexts, enhancing the knowledge surrounding acute appendicitis diagnosis.

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Ultrasonography in Patients with Suspected Acute Appendicitis

Cited by 7 publications

References 12 publications

A Clinicopathological Study to Establish the Correctness of the Diagnosis of Acute Appendicitis in Cases of Acute Right Lower Quadrant Pain of Abdomen

A Clinicopathological Study to Establish the Correctness of the Diagnosis of Acute Appendicitis in Cases of Acute Right Lower Quadrant Pain of Abdomen

A clinicopathology study to establish the accuracy of diagnosis of acute appendicitis in case of acute right lower quadrant pain of abdomen

A prospective observational comparative study to compare the diagnostic efficacy of the Fenyo Lindberg scoring system and Yash scoring system in patients of acute appendicitis in tertiary care hospitals in central India

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