Diagnostic Accuracy of Graded Compression Ultrasonography in Diagnosis of Acute Appendicitis Taking Histopathology as Gold Standard

Acute appendicitis is a common surgical abdominal emergency in this part of the world with a life time prevalence of one in seven. As this disease is amenable for treatment by surgery, early diagnosis plays an important role in treatment and in preventing undue complications. The objective of this study was to determine diagnostic accuracy of graded compression ultrasonography in the diagnosis of acute appendicitis taking histopathological as gold standard. This was a prospective study was carried out in the Department of Radiology at Nepal Mendicity Hospital Brhaspati, Lalitpur, Nepal. All the patients with a clinical diagnosis of Acute Appendicitis underwent Graded Compression Ultrasonography and their findings were documented on a proforma. All the patients who underwent Appendectomy were followed on and histopathology diagnosis was considered as Final Diagnosis. Sonographic and histopathological diagnosis were correlated. Out of a total of 102 cases studied, 97 (95%) were diagnosed to have Acute Appendicitis, rest had alternate diagnosis. The sensitivity, specificity, positive predictive value and negative predictive value of graded compression ultrasonography in the diagnosis of acute appendicitis was 90.72 %, 40 %, 96.7 % and 18.18 % respectively. The false negative value was 0.09 and false positive value was 0.6. Graded Compression Ultrasonography is highly accurate to diagnose appendicitis. The accuracy afforded by sonography will help keep negative appendectomy rates down, clearly an improvement over the rate achieved by clinical diagnosis alone.