Ultrasonogram in Acute Appendicitis, A Surgeon’s Perspective: Original Article
Amar Verma
Department of Surgery, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda HP, India.
Rajesh Chaudhary *
Department of Surgery, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda HP, India.
Ramesh Bharti
Department of Surgery, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda HP, India.
Kulbhushan Sharma
Department of Urology, All India Institute of medical sciences, New Delhi, India.
Rajesh Sharma
Department of Surgery, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda HP, India.
Vikrant Sharma
Department of Surgery, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda HP, India.
*Author to whom correspondence should be addressed.
Abstract
Introduction: The diagnosis of acute appendicitis has essentially been clinical, but USG abdomen has been said to be highly accurate in diagnosing AA. The surgeon’s perspective may not always be the same.
Materials and methods: Appendectomy data of 106 patients from two hospitals of Kangra region was retrospectively analysed. The data was collected for age, sex, initial pre-operative diagnosis, USG findings, intra-operative findings, Histo-pathological examination (HPE) report, post operative hospital stay.
Observations: It revealed a sensitivity of about 54% and specificity of 100% for diagnosing AA with the help of USG abdomen. AA was seen most commonly in males as compared to females. Mean age of presentation was 29.34 +/- 14.4 years. Mean hospital stay was 3.68 +/- 2.25 days. Most common initial preoperative diagnosis was AA (84%). Most common position of the appendix during surgery was retrocecal (53.7%). HPE report revealed AA in 105 patients.
Conclusion: USG abdomen is often falsely assuring, leading to unnecessary delay in effectively managing a patient of AA further leading to increased complications. Only the clinically equivocal cases require further radiological investigations where CECT abdomen is the preferred investigation, but it should be used judiciously.
Keywords: Acute appendicitis, alvarado score, appendicular lump, graded compression ultrasonogram.