Diagonstic performance of ultrasonography and computed tomography in acute appendicitis in tertiary care centre

Abstract

Background: Appendicitis is the commonest cause of acute abdominal pain requiring emergency surgical intervention. Mimickers of Acute Appendicitis is hard to be to ruled out clinically, wherein lies the importance of imaging. Aims: To evaluate the Sensitivity and Specificity of CT and USG in diagnosing Acute Appendicitis wih Histopathology and Surgical correlation of radiological finding.Methodology: Comparative study between Ultrasonography and Computed Tomography was done between September 2018 and September 2020, involving a pool of 75 patients clinically suspected as acute appendicitis. All the patients were subjected to both USG and CECT modalities in same setting, with chief complaint of acute right lower abdominal pain, vomiting, and sometimes fever. Both the imaging finding were compared with histopathology specimen following appendectomy.Results: Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value, and Accuracy of USG is 84%, 67%, 98%,15%, and 85% respectively and for CT the Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value and Accuracy of CT is 98%, 100%, 100%, 75% and 99% respectively.Conclusion: Ultrasound should be initial modality in all cases presenting as Acute Appendicitis, but in cases where it is equivocal and undetected CECT has advantage not only detecting but also providing surgical planning for surgeons basing on different anatomical locations and ruling out other differentials of right iliac fossa pain.