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Category: Volume 09 Issue 01 January 2021
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Title: Comparative Study of Sensitivity and Specificity of Ultra Sonagraphy and Computed Tomographyin Clinically Suspected Acute Appendicitis as Adiagnostic Tool and Further Confirmed and Correlated with HPE

Authors: Dr P. Rajeswari, MD, DCP, Dr G. Kavithal, MS (General Surgery)

 DOI: https://dx.doi.org/10.18535/jmscr/v9i1.25

Abstract

Introduction: The vermiform appendix, which for a long time was thought as a vestigial organ turned out to be an immunological organ. Immunoglobulin A is the predominant immunoglobulin secreted by the appendix. The acute inflammation of this organ is called as Acute appendicitis. Surgical emergency is supposed to be acute appendicitis. The diagnosis is based mainly on clinical exam. But now the drastic improvement in imaging techniques has been h. This prospective study compares the sensitivity and specificity of Ultrasonography and Computed tomography, as a diagnostic tool in the patients clinically diagnosed as acute appendicitis and confirmed and correlated with histopathological examination post operatively.

Study Design: First nearly One hundred and forty-nine patients with symptoms of abdominal pain, vomiting, fever was selected and the Alvarado scoring system was followed. Patients who had scoring above seven were considered. All patients underwent Ultrasonogram. Those who did not show appendicitis were taken for computerised tomogram. All patients who were diagnosed by the imaging techniques and the clinically suspected acute appendicitis were taken up for the procedure.  After the surgery the specimen taken for histopathological examination and the results compared.

Results: For ultrasonography, the sensitivity was 65%, the specificity was 77%, the positive predictive value was 92%, and the negative predictive value was 38%. Comparatively for Computerised tomogram the sensitivity was 93%, the specificity was 94%, the positive predictive value was 97%, and the negative predictive value was 87%. The combined values for ultrasonography and computed tomography (in inconclusive ultrasonographic cases only) was sensitivity 98% , specificity 70% , positive predictive value 93% , negative predictive value was 86% and the most important, diagnostic accuracy was 92% .

Conclusion: In diagnosing acute appendicitis the computed tomogram is found to be better than ultrasonogram. So, we can combine computed tomography with ultra-sonogram  for only patients who are inconclusive with ultra-sonogram, thereby saving cost, radiation, time, and manpower.

Keywords: Histo pathological examination, Alvarado scoring, ultra-sonogram (USG), sensitivity, specificity, Computerised tomogram (CT).

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Corresponding Author

Dr G. Kavithal

Assistant Professor, Department of General Surgery, Government Erode Medical College, Erode