Usefulness of abdominal ultrasound in acute painful episodes of the right iliac fossa that are suspicious of appendicitis

An experience at the Maciel Hospital

Abstract

Introduction: acute appendicitis is one of the most frequent causes of consultation and of indication of emergency laparotomy in most western countries. Despite its diagnostic being based mainly on clinical examination, there is a certain percentage of patients whose clinical presentation is atypical. In these cases image methods such as the abdominal ultrasound are particularly useful as diagnostic auxiliaries.
Objectives: we conducted a prospective study with the objective of assessing the usefulness of this image method in our hospital, and studied 80 patients who consulted the emergency service with episodes the were compatible with acute appendicitis.
Method: we compared the echographic findings with the anatomopathological diagnosis, calculating the sensitivity, specificity and the positive and negative predicting values of the method, discriminated by sex and by technician. We compared these results with the results obtained in other series.
Results: echographies had a rate of false negatives of 33.75% (27/80). Global method sensitivity was 45.5% and the negative predicting value was 15.6%.
Conclusions: we concluded that for the time being, this is not a reliable diagnostic tool to discard appendicitis; it may me useful when findings are positive since positive predictive values are acceptable.