Ultrasound in the diagnosis of appendicitis: a plea for caution

Background/Objectives: Acute appendicitis is one of the most frequent causes of acute abdomen. The clinical diagnosis is based on the case history and the physical examination. However, in some cases the typical clinical symptoms are equivocal or misleading at which time, making the diagnosis of appendicitis may be considerably difficult. Ultrasound may play a role in this class of patients. This article assesses the accuracy of this adjunctive test at our centre
Methods: This is a six-year retrospective study from July 2000 to July 2005 looking at patients that had appendicectomy done at Ahmadu Bello University Teaching Hospital Kaduna Nigeria. We analyzed postoperatively those with histological diagnosis of appendicitis who at the same time had preoperative ultrasound assessment for the main purpose of establishing appendicitis. The final histopathological evaluation was used as the standard to rate the efficacy of ultrasonographic diagnosis of appendicitis.
Results: One hundred and forty nine patients 149 were documented. 128 had adequate data for further analysis and only. 78patients (60%) had ultrasound before surgery. The actual diagnostic accuracy of ultrasound in our environment is 24.4%.
Conclusions: Ultrasonography routine use in all our patients suspected of having classical appendicitis cannot be advocated at present.