Ultrasound Value in Diagnosis of Acute Appendicitis at Al-diwaniyah Teaching Hospital-Iraq

Abstract

Background: Ultrasound has been widely available and usable imaging technique help in assessment and
diagnosis of various diseases. The use of ultrasound as diagnostic tool for diagnosis of appendicitis has been
established, but the real value of use of ultrasound not clearly observed, the aim of our study to clarify the
negativity of the predictive value of ultrasound study for acute appendicitis (NVP).
Method: Ultrasound study of the abdomen with focusing on right iliac fossa done for 100 patient clinically
suspected to have acute appendicitis and a scale of one to three given for sonographic results range from
negative (score 1) to confirmed appendicitis (score 3), the result compared with the CT – scan finding and
specimen pathology after surgical intervention.
Result: Seventy four (74) patient were negative by ultrasound, while twenty six (26) patient has score of 3
ultrasonic features of acute appendicitis, CT scan examination with contrast adding another ten (10) patient
proved to have appendicitis (i.e changing from negative to positive appendicitis by CT findings) and fifteen
(15) patient with other diagnosis or discharged, so total positive cases where thirty six (36) patients whom
underwent surgical intervention, from those were thirty (30) patient confirmed appendicitis by pathological
result (83%), So the negative predictive value for the ultrasound diagnosis of appendicitis (NVP = 95.1%).
Conclusions: Ultrasound had an overall lower sensitivity in diagnosing appendicitis in our study, but
with high specificity, however, with various studies when the appendix was not clearly identified, CT-scan
assessment should be considered .