Ultrasonography in Patients with Suspected Acute Appendicitis |
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| Authors: | J Debnath Sree Ram S Balani I Chakraborty PD Gupta RK Bindal P Sengupta |
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| Institution: | 1. Grup Recerca Addiccions Clínic (GRAC-GRE). Institut d''Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic Barcelona, Barcelona 08036, Spain;2. Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands;3. University Institute of Maia - ISMAI and Interdisciplinary Research Centre for Human Rights - JusGov, University of Minho- Avenida Carlos de Oliveira Campos, 4475-690 Maia, Portugal and JusGov - Escola de Direito, Campus de Gualtar, Braga 4710-057, Portugal;4. King''s College London, Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, London SE5 8BB, United Kingdom;5. Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University (UA), Belgium. European Federation of Addiction Societies (EUFAS), Belgium;6. Psychology Department, Ariel University, Ariel, Israel;7. Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, United Kingdom;8. Clinical Psychopharmacology Unit, Research Department of Clinical and Health Psychology, University College London, London WC1E 7HB, United Kingdom;9. Departament of Sociology, Purdue University, United States;10. Bonger Institute of Criminology, University of Amsterdam, the Netherlands;11. School of Behavioural & Health Sciences Faculty of Health Sciences, Australia;12. Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, Dresden 01187, Germany;13. European Monitoring Centre for Drugs and Drug Addiction, Portugal;14. Institute for Mental Health Policy Research & Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Canada;15. Center for Interdisciplinary Addiction Research (ZIS) of Hamburg University, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg 20246, Germany;p. Public Health Institute, Liverpool John Moores University, Exchange Station Tithebarn Street, Liverpool L2 2QP, United Kingdom;q. Student Governance and Leadership in European Public Health, Maastricht University, the Netherlands;r. Department of Sociology, The Ohio State University, Columbus, OH, United States;s. Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland; University of Michigan, Ann Arbor, MI, United States;t. NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom;u. Center for Interdisciplinary Addiction Research of Hamburg University (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg 20246, Germany;v. Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, Leipzig 04103, Germany;w. Dalla Lana School of Public Health and Department of Psychiatry, University of Toronto (UofT), Canada;x. Epidemiological Research Unit, Technische Universität Dresden, Klinische Psychologie & Psychotherapie, Dresden, Germany;y. Department of International Health Projects, Institute for Leadership and HealthManagement, I.M.Sechenov First Moscow State Medical University, Moscow, Russian Federation;1. Department of Computer Science and Engineering, Institute of Technology, Nirma University, Ahmedabad - 382 481, Gujarat, India |
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| Abstract: | BackgroundTo evaluate the usefulness and limitations of graded compression ultrasonography in the diagnosis of clinically equivocal cases of suspected acute appendicitis at the setting of mid zonal military hospital of India.MethodsA prospective study, graded compression ultrasonography with self localization was carried out with 3.5 MHz convex, 5 MHz convex and 7.5 MHz linear transducers (Wipro GE) in 69 clinically equivocal suspected cases of acute appendicitis. With maximal compression the anteroposterior diameter of appendix was measured from outer to outer wall. The main criterion for diagnosing appendicitis was demonstration of a non compressible appendix with anteroposterior dimension of 7mm or more.ResultSonologically 36 (52%) cases were diagnosed as appendicitis. Anteroposterior outer diameter of inflamed appendices ranged from 7mm to 21mm (mean 10.5mm). 30 (83%) of 36 patients could accurately self localize the point of maximum tenderness. There were 01 false positive and 04 false negative cases. Sensitivity and specificity were 89.7% and 96.6% respectively. Positive and negative predictive values were 97.2% and 87.8% respectively. Alternative diagnoses were offered in 33 (47.8%) cases. Amongst these 33 cases, 14(42.4%) had abdominal pain of unknown origin. Gynaecologic, urologic and gastrointestinal aetiologies were established in 10(30.3%), 07(21.2%) and 02(6%) cases respectively.ConclusionGraded compression ultrasonography superadded with self localization is an accurate means of diagnosing/excluding appendicitis in clinically equivocal cases of acute appendicitis and it is of great value in establishing alternative diagnoses.Key Words: Ultrasonography, Acute appendicitis |
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| Keywords: | Ultrasonography Acute appendicitis |
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