scholarly journals Diagnostic role of Ultrasonography in acute appendicitis

2015 ◽  
Vol 10 (1) ◽  
pp. 45-49
Author(s):  
Md Khairul Islam ◽  
Md Selim ur Rahman ◽  
Syed Zoherul Alam ◽  
Arif Ahmed Khan ◽  
Md Tarikul Islam ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Predictive Value ◽  
Histopathological Examination ◽  
Iliac Fossa ◽  
Lower Abdominal Pain ◽  
Armed Forces ◽  
Compression Technique ◽  
Abdominal Ultrasonography

Introduction: Abdominal Ultrasonography (USG) is the most commonly used method for diagnosing acute appendicitis the most common surgical cause of acute abdomen. In this study, we observed the reliability of USG for diagnosing acute appendicitis. Objectives: To evaluate the role of ultrasonography in the diagnosis of acute appendicitis. Methods: In this study, we performed abdominal USG of 100 patients admitted with lower right abdominal pain and diagnosed as acute surgical abdomen according to the physical examination and laboratory findings. These patients were surgically treated by appendecectomy, and excised specimens were sent for histopathological examination. Results: One hundred patients were assessed in this study. Out of them 82.0% patients had acute appendicitis and diameter of their appendices were more or equal to 6 mm. Twenty nine percent of the patients were below 21 years of age. Intraluminal fluid was present in 81% of patients and peri-appendicular fluid was present in 66.7% of patients. Leucocytosis was present in 49% of the cases and neutrophilia in 84% of the cases. All of the patients presented with lower abdominal pain with migration of pain in 52% cases and they had right iliac fossa tenderness. The sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and accuracy rate of ultrasonography was 76.8%, 88.9%, 96.9%, 45.7% and 79.0%, respectively. 45 JAFMC Bangladesh. Vol 10, No 1 (June) 2014 Conclusion: Acute appendicitis is a common indication for emergency abdominal surgery. Proper clinical assessment is the mainstay of diagnosis in acute appendicitis and addition of routine abdominal ultrasound by graded compression technique can improve the diagnostic accuracy and adverse outcome. DOI: http://dx.doi.org/10.3329/jafmc.v10i1.22904 Journal of Armed Forces Medical College Bangladesh Vol.10(1) 2014

scholarly journals Diagnostic Value of Ultrasonography in Patients Suspected Acute Appendicitis

2013 ◽  
Vol 2 (2) ◽  
pp. 13-19
Author(s):  
MA Elahifar ◽  
H Taheri ◽  
A Bighamian
Keyword(s):  
Acute Appendicitis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Histopathological Examination ◽  
Imaging Modality ◽  
Diagnostic Value ◽  
Preoperative Imaging ◽  
Outpatient Basis ◽  
Abdominal Ultrasonography ◽  
Cell Counts

Introduction: Appendectomy is one of the most frequently performed abdominal operations in surgical practice. Preoperative imaging has been demonstrated to improve diagnostic accuracy in appendicitis. Abdominal ultrasonography (US) is the most commonly and first-line imaging modality used for diagnosing acute appendicitis (AA).The aim of this study was to demonstrate the diagnostic value of abdominal ultrasonography for diagnosing acute appendicitis. Methods: In a retrospective study, we analyzed 200 consecutive patients with abdominal pain that undergoing appendectomy, from June 2009 to April 2012. Patient characteristics, preoperative ultrasonography (US) and laboratory assessment including WBC were collected. Final diagnosis of appendicitis was confirmed by histopathological examination. Results were compared with US. Results: Two hundred patients were admitted to this study that undergoing appendectomy. Mean age was 24 years (range: 1 to 91 years), and 57% were females. Patient White blood cell counts were found to be high in 78% while it was 86% for AA group and 64% for NA group (p < 0.05). One hundred sixty-six of these patients (83%) were diagnosed as acute appendicitis on pathology, and 34 (17%) were diagnosed differently. 157 of patients underwent US, eighty two of this patients diagnosed as acute appendicitis on US examinations and in 78 of them were also reported as acute appendicitis on histopathological examination. The sensitivity and specificity of abdominal US for diagnosing appendicitis were 70% and 90.2% respectively. Positive predictive value (PPV) was 93% and negative predictive value (NPV) was reported 62%. Conclusion: Ultrasonography has a high PPV and specificity, so as a diagnostic tool, positive US strongly suggests the diagnosis of AA. A low negative predictive value recommends that negative US is not sufficient to exclude the diagnosis of AA and patients could not be managed on an outpatient basis following a negative scan. Nepalese Journal of Radiology; Vol. 2; Issue 2; July-Dec. 2012; 13-19 DOI: http://dx.doi.org/10.3126/njr.v2i2.7680

scholarly journals Torsion of caecal appendices epiploicae: mimicking acute appendicitis

2020 ◽  
Vol 7 (7) ◽  
pp. 2407
Author(s):  
A. P. Roshini ◽  
Dattaprasad Samant ◽  
F. P. Noronha
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Iliac Fossa ◽  
Lower Abdominal Pain ◽  
Free Fluid ◽  
Normal Appendix ◽  
Menstrual Cycles ◽  
Rebound Tenderness ◽  
Appendices Epiploicae ◽  
The Right

Acute appendicitis is a common cause for pain in the right iliac fossa, which requires urgent surgical intervention. However, at the time of surgery, if the appendix is normal, the surgeon has to search for other causes of acute abdominal pain including rare etiologies, such as torsion of appendices epiploicae and subsequently its gangrene. We report the case of a 45 years old female who presented with right lower abdominal pain, rebound tenderness and guarding in right iliac fosse, with regular menstrual cycles and no urinary complaints. Investigation revealed leucocytosis and ultra-sonography abdomen was suggestive of an inflamed appendix in the right iliac fossa with free fluid. Intra-operatively, we found a normal appendix with gangrene of the appendices epiploicae which had undergone torsion. She underwent excision off appendices epiploicae with appendicectomy with uneventful post-operative period. Histopathology of the appendices was suggestive of congestion.  Preoperative diagnosis of this condition is rarely made.

scholarly journals Role of Graded Compression Ultrasonography in Evaluation of Acute Appendicitis.

2015 ◽  
Vol 12 (2) ◽  
pp. 49-53
Author(s):  
Mukunda Singh Shrestha ◽  
Hom Prasad Pant ◽  
Shiv Bahadur Basnet ◽  
Govinda Bhahadur Khadka ◽  
Rajive Raj Shahi ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
Iliac Fossa ◽  
Clinical Impression ◽  
High Morbidity ◽  
Emergency Setting ◽  
Compression Technique ◽  
Suspected Appendicitis ◽  
Right Iliac Fossa Pain ◽  
Compression Ultrasonography

Introduction: Acute appendicitis is common surgical emergency which can lead to high morbidity and mortalityin absence of timely treatment. Ultrasonography (USG) is commonly used to diagnose appendicitis and excludeother intraabdominal pathology leading to right iliac fossa pain in emergency setting. We aimed to Þ nd out thediagnostic value of graded compression USG in suspected appendicitis cases.Methods: Altogether 107 patients with clinical impression of acute appendicitis were followed. Four caseswere excluded because of other diagnosis established in USG. Appendicitis was diagnosed by standard criteriasof inß ammed appendix by graded compression technique. Informations of 103 cases were recorded in proformawhich was later entered in SPSS and statistical calculations done.Results: Out of 103 cases followed, 93 had appendicitis. Of those, 46 cases only showed inß ammed anddistended appendix, others showed ancillary features only. Males were more affected 61(65.6%) than females.Sensitivity, speciÞ city, positive predictive value, negative predictive value and accuracy of ultrasound indetecting appendicitis were 98.9%,90%,98.9%,90% and 97.1% respectively.Conclusions: Graded compression ultrasonography is good investigation modality in assessement of suspectedacute appendicitis.doi: http://dx.doi.org/10.3126/mjsbh.v12i2.12929

scholarly journals Clinicopathological evaluation of acute appendicitis and the role of ultrasound in diagnosis: a prospective study

2019 ◽  
Vol 6 (5) ◽  
pp. 1471
Author(s):  
Tony Mathew ◽  
Amit Shivshankar Ammanagi
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Prospective Study ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Scoring System ◽  
Lower Abdominal Pain ◽  
Negative Appendicectomy ◽  
A Prospective Study

Background: Acute appendicitis is the most common acute surgical condition of the abdomen. Delay in treatment of acute appendicitis causes lot of complication. Study was done with the objective to study the clinical and pathological presentations of acute appendicitis, to evaluate the role of ultrasound in early diagnosis of acute appendicitis and to reduce negative appendicectomy in patients.Methods: This is a prospective study done on 100 patients with acute right lower abdominal pain clinically presumed to be of appendicular origin. A thorough history, clinical examination and ultrasound scan, was done for all cases. All ultrasound positive cases were subjected to surgery and some negative cases were also taken for surgery based on clinical suspicion. The ultrasound diagnosis was compared with clinical findings, operative findings and histopathological examination reports.Results: The overall accuracy of clinical diagnosis (Alvarado scoring system) with histopathology findings was 72%. The overall sensitivity and specificity was 70.3% and 81.3% respectively and positive predictive value of was 95.2% whereas the negative predictive value was 34.2%. The overall accuracy of ultrasound with histopathology report was 93%, with a sensitivity of 96.4%, specificity of 75%, and a positive predictive value of 95% and a negative predictive value of 80%. Negative appendicectomy rate was 8.82% in females and 3.63% in males.Conclusions: The Alvarado scoring system combined with ultrasound can therefore be used as a cheap and inexpensive way of confirming acute appendicitis thus reducing negative appendicectomy rate.

scholarly journals Caecal Epiploic Appendagitis Masquerading Clinically as an Acute Appendicitis: A Case Report and Brief Literature Review

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Tallat Ejaz ◽  
Eltaib Saad ◽  
Andik Nabil ◽  
James Slattery
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Iliac Fossa ◽  
Lower Abdominal Pain ◽  
Good Health ◽  
Final Diagnosis ◽  
Epiploic Appendagitis ◽  
Rebound Tenderness ◽  
History Of ◽  
The Right

A 46-year-old female presented to our emergency department (ED) with a 2-day history of right lower abdominal pain which was associated with nausea and anorexia. Abdominal examination revealed tenderness in the right iliac fossa (RIF) with rebound tenderness and a localized guarding. Urine dipstick was normal, and the pregnancy test was negative. Her laboratory investigations were significant only for a CRP of 16.6. A presumptive clinical diagnosis of acute appendicitis was suggested based on the given history and relevant physical signs. However, an abdominal computed tomography (CT) scan revealed an epiploic appendagitis of the caecum with a normal-looking appendix. She was managed conservatively and responded well and was discharged after 2 days in good health. Though being a relatively rare case of acute localized right-sided lower abdominal pain, caecal epiploic appendagitis should be considered as one of the differential diagnoses with the final diagnosis reached usually by the radiological findings due to the nonspecific nature of clinical and laboratory features.

scholarly journals Accuracy of Ultrasonogram in Diagnosis of Acute Appendicitis

2016 ◽  
Vol 12 (1) ◽  
pp. 33-37
Author(s):  
Rosy Perveen ◽  
AFMS Islam ◽  
Habibur Rahman ◽  
Ruksana P Khan
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
Histopathological Examination ◽  
Armed Forces ◽  
Medical College ◽  
Rebound Tenderness ◽  
Common Causes ◽  
Operative Findings ◽  
The Cost ◽  
Work Up

Introduction: Acute appendicitis is one of the most common causes of abdominal pain of adult patients referred to the emergency department. Despite its prevalence, the diagnosis of appendicitis can be elusive and fraught with pitfalls because of the absence of a pathognomonic sign or symptom and the poor predictive value of laboratory testing. So following the significant advances in accuracy, ultrasonography has become an important part of the modern work-up of acute appendicitis. Objective: To evaluate the role and accuracy of ultrasonography in the diagnosis of acute appendicitis. Materials and Methods: A total number of 110 cases (65 men and 45 women), with clinical suspicion of appendicitis, were subjected to abdominal ultrasonographic examination. All ultrasonographic positive cases and a few of ultrasonographic negative cases were subjected to operative intervention.The accuracy of ultrasonography in the diagnosis of appendicitis was compared with the clinical diagnosis, operative findings and histopathological examination reports. The statistical analysis was done by using SPSS10. Results: Among 110 cases, 77 cases were sonographically positive for appendicitis and 5 cases were appendicular masses. The cardinal signs were right lower abdominal tenderness, rebound tenderness and positive Rovsing’s sign. The specificity of Ultrasound was 74.28%, sensitivity 90.66%, positive predictive value 88.31%, negative predictive value 78.79% and accuracy was 85.45% in the diagnosis of acute appendicitis. Conclusion So far the cost reduction of treatment and negative laparotomies are concerned, the ultrasonography is still an useful tool in the diagnosis of appendicitis in spite of more recent investigations like CT abdomen and Laparoscopy. Journal of Armed Forces Medical College Bangladesh Vol.12(1) 2016: 33-37

scholarly journals Evaluation of Ripasa scoring system for diagnosis of acute appendicitis.

2020 ◽  
Vol 27 (08) ◽  
pp. 1541-1545
Author(s):  
Movahid Anwer ◽  
Shabbir Ahmed ◽  
Muhammad Fazal ur Rehman
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
Scoring System ◽  
P Value ◽  
Negative Appendectomy ◽  
Abdominal Ultrasonography ◽  
Ethical Approval ◽  
Sensitivity Specificity ◽  
Study Setting

Objectives: To evaluate the role of RIPASA scoring system for diagnosis of acute appendicitis taking histopathology as gold standard. Study Design: Prospective Study. Setting: Department of General Surgery, Nishter Hospital Multan. Period: February 2016 to February 2017. Material & Methods: One hundred and sixty 160 patients were included in this study. Study was started after ethical approval from ethical board of institution and informed consent from patients was taken. Non probability consecutive sampling was used. Main outcome variables were sensitivity, specificity and diagnostic accuracy of RIPASA score. SPSS version was used to analyze data. P value ≤ 0.05 was considered as significant. Results: Estimated sensitivity was 97.9%, which means that of the patients with acute appendicitis, 97.9% were diagnosed correctly. The estimated specificity was 76.9%, which means that of the patients not having acute appendicitis, 76.9% were diagnosed correctly. Positive predictive value was 86.1% and negative predictive value was 96.2%. The overall accuracy was 89.4% for diagnosing acute appendicitis. Conclusion: RIPASA scoring system is efficient, reliable and more diagnostic in cases of acute appendicitis. Abdominal ultrasonography is not suitable diagnostic tool to rule out negative appendectomy.

scholarly journals Diagnostic efficacy of ultrasonography in acute appendicitis

2013 ◽  
Vol 34 (3) ◽  
pp. 8-11
Author(s):  
B Lohani ◽  
G Gurung ◽  
S Paudel ◽  
P Kayastha
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Histopathological Examination ◽  
Institute Of Medicine ◽  
Compression Technique ◽  
Diagnostic Efficacy ◽  
Cross Sectional ◽  
Suspected Acute Appendicitis

Introduction: Acute appendicitis is the most common acute condition of the abdomen requiring surgery in both adults 1,2 and children. 3.5 The overall frequency of appendicitis for symptomatic patients younger than 20 years is 41%; the frequency for those older than 20 years is 59%. Methods:  This was a prospective cross sectional study involving 104 patients aged between 8 and 68 years with clinical suspicion of acute appendicitis. Patients with suspected acute appendicitis were evaluated with high frequency linear transducer using graded compression technique. Peroperative findings were noted and histopathological examination were carried out in all the cases for confirmation of acute appendicitis. Sensitivity, specificity, negative predictive value, positive predictive value and accuracy of ultrasonography were calculated by using statistical method. Results: Among 104 patients (61 males and 43 females) with clinical diagnosis of acute appendicitis, ultrasonography was positive for acute appendicitis in 79 patients (75.96%). On histopathological examination, 94 appendices (90.38%) were acutely inflamed. The sensitivity of ultrasonography for the diagnosis of acute appendicitis was 78.72% with specificity of 60%. Positive predictive value, negative predictive value and accuracy of ultrasonography were 94.87%, 23.07% and 76.92% respectively. Conclusion: Ultrasonography is a useful method of diagnosing clinically suspected acute appendicitis especially in doubtful cases. DOI: http://dx.doi.org/10.3126/joim.v34i3.8908   Journal of Institute of Medicine, December, 2012; 34:8-11

scholarly journals Torsion hematosalpinx concurrent with acute appendicitis

2021 ◽  
Vol 10 (10) ◽  
pp. 3973
Author(s):  
Vishwa G. Kanabar ◽  
Ravi N. Kotecha ◽  
Ramesh Thakan
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Fallopian Tube ◽  
Diagnostic Laparoscopy ◽  
Iliac Fossa ◽  
Lower Abdominal Pain ◽  
Acute Onset ◽  
Cystic Mass ◽  
Diagnostic Dilemma ◽  
Ovarian Pathology

Isolated fallopian tube torsion is very rare which is reported to be 1 in 1.5 million women. Fallopian tube torsion is commonly associated with hydrosalpinx, hematosalpinx or paratubal cysts such as hydatids of Morgagni. Fallopian tube torsion generally presents a diagnostic dilemma because symptoms and signs mimics ovarian torsion such as acute lower abdominal pain, vomiting, tenderness on palpation but ultrasound may show normal ipsilateral ovary. Right sided adnexal torsion may be difficult to differentiate from acute appendicitis clinically. In such cases ultrasound is helpful but diagnostic laparoscopy is gold standard. We encountered a rare case of torsion hematosalpinx concurrent with acute appendicitis. Patient was presented with acute onset severe lower abdominal pain associated with vomiting and tenderness in right iliac fossa. It was diagnosed as acute tip appendicitis and right adnexal cystic mass either hydrosalpinx/hematosalpinx in ultrasonography. Laparoscopy was done and it was found to be right sided torsion hematosalpinx along with inflamed tip of appendix. Right sided salpingectomy and appendicectomy was done laparoscopically. Fallopian tube torsion should be suspected and diagnostic laparoscopy should be considered in cases of acute onset lower abdominal pain in which ovarian pathology was not found in ultrasonography, that helps in earlier intervention and even in early cases fallopian tube can be salvaged.

Imperforate hymen mimicking acute appendicitis in an adolescent woman: a rare presentation

2021 ◽  
Vol 14 (3) ◽  
pp. e238547
Author(s):  
Victoria Rose Russell ◽  
Mohamed Ibrahim ◽  
Georgina Phillips ◽  
Tom Setchell ◽  
Sanjay Purkayastha
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Iliac Fossa ◽  
Female Genital Tract ◽  
Delayed Diagnosis ◽  
Rare Presentation ◽  
Left Iliac Fossa ◽  
Imperforate Hymen ◽  
Retrograde Menstruation ◽  
Low Incidence

Imperforate hymen is a rare congenital malformation of the female genital tract. The condition poses several diagnostic challenges owing to its low incidence and often atypical presentation. Classical symptoms include amenorrhoea and cyclical abdominal pain. Delayed diagnosis leads to potentially irreversible and lifechanging sequelae including infertility, endometriosis and renal failure. A premenarchal 13-year-old girl with a background of chronic constipation presented with symptoms mimicking acute appendicitis. The underlying cause was imperforate hymen and retrograde menstruation. The diagnosis was made during diagnostic laparoscopy. As with this patient, pre-existing symptoms are often troublesome long before the true diagnosis is made. This case report highlights the importance of recognising imperforate hymen as a potential cause of acute abdominal pain in premenarchal adolescent girls. The clinical picture may present as right or left iliac fossa pain. Early identification reduces the risk of adverse complications and avoids unnecessary and potentially harmful interventions.

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