The effect of emergency surgeon-performed sonography on diagnostic accuracy of appendicitis


The diagnosis of acute appendicitis, which is highly prevalent surgical emergency, remained mainly a clinical diagnosis with high false negative and false positive rates. Emergency surgeon can play important role in using some modern diagnostic facilities like ultrasonography (US) to improve the diagnosisAims: To evaluate the role of ultrasonography performed by emergency surgeon in improving the diagnosis of acute appendicitis.Patients and methods: A prospective study over two years on 290 patients with acute appendicitis. We allocated the patients into two group depending on the way of their diagnosis whether US used or not in their diagnosis and the operative state of the appendix and the histopathological results were recorded.Results: The negative appendectomy rate in group 2 patients (US was used in their diagnosis) was lower than in-group 1(US was not used in their diagnosis) 7.2% vs 25%. In group2, the diagnostic accuracy was 79.3%, the sensitivity rate 75.5%, the specificity rate 89.3%, Positive predictive value 95% and the Negative predictive value 57.5%. The results in our study were near or within the results of studies performed by professional sonographerConclusions: There are important roles for US as diagnostic tool in patients with clinical diagnosis of acute appendicitis; as it improves the diagnostic accuracy of appendicitis and reduces the negative appendectomy, but non-appendicitis US result is not enough to exclude acute appendicitis. The emergency surgeon with proper US training can perform US examination successfully since the results are similar to that performed by professional sonographers.