Evaluation of the diagnostic yield of ultrasound in the management of appendicitis: An experience in a tertiary hospital in South-Eastern Nigeria

Abstract

Introduction: In most complaints of right lower abdominal pains appendicitis is suspected. Appendicitis often creates the most common abdominal surgical emergency. Ultrasound and computed tomography are often the imaging modalities used to confirm the clinical diagnosis of appendicitis. The aim of this study was to evaluate the accuracy of ultrasound in the diagnosis of appendicitis in a tertiary hospital in South Eastern, Nigeria. Materials and Methods: A retrospective study design was adopted to study 152 records of patients aged 1–65 years who had ultrasound scans for clinical suspicion of appendicitis at a tertiary hospital in Anambra State, South Eastern Nigeria from 2016 to 2018. Patients' age, gender, and provisional diagnosis were obtained from the patients' request forms. Ultrasound results were obtained from the radiology department and the histology reports from the histology unit of the hospital. The Statistical Package for the Social Sciences, SPSS, version 22.0. was used for data analysis. Results: Of the 152 cases, ultrasound was positive in 115, while histology confirmed 136 positives. Ultrasound, therefore, had a sensitivity, specificity, and accuracy of 84.56%, 100%, and 86.18%, respectively. The positive predictive value and negative predictive values were 100% and 43.24%, respectively. The study showed a higher incidence of appendicitis among females (n = 84) than males (n = 52), (ratio 1:1.6). Age groups 10–19 and 20–29 years were the most affected. Accuracy was 91.94% (in males) and 82.22% (in females). The most common ultrasound features include enlarged appendix (>9 mm, 100%), rebound tenderness to probe (92%), and fluid-filled appendix (88%). Conclusions: Ultrasound has high sensitivity, specificity, and accuracy for the diagnosis of appendicitis.