Sensitivity and Specificity of CT scan Abdomen in diagnosing Appendicitis

Introduction: Appendicitis is one of the commonest surgical emergencies. Although diagnosis is straightforward in most of the cases but some of the cases it is challenging and imaging is needed to rule out other causes of right lower abdominal pain. This is especially important in female patients where uterine and ovarian pathologies can present in similar ways and it becomes mandatory to get imaging done to accurately diagnose the disease. Use of imaging not only helps in difficult cases to accurately identify the disease but is also now used liberally because of increasing medicolegal issues and in cases where patient wants to be quite sure of diagnosis before undergoing surgical intervention. While no imaging modality can 100 percent diagnose or exclude the diagnosis but these modalities combined with clinical and radiological adjuncts significantly improve diagnostic certainty. Aim: Use of radiology in diagnosing appendicitis is no more limited to complicated and dubious cases and is more often than past. The idea of conducting this audit was to see how frequently radiology is used in our department for diagnosis of acute appendicitis, what are the modalities used for diagnosis and what is the specificity and sensitivity of different radiological procedures for accurate diagnosis, the gold standard to compare being final histopathology of appendix. Methods: Records of all patients who underwent appendectomy in Dubai Hospital, UAE from jan 2018 to jan 2019 were retrospectively analyzed using electronic record system. Clinical diagnosis and radiological findings were compared with histopathology as gold standard for negative appendectomy rate. The sensitivity and specificity of different radiological procedures was calculated as well. Results: Total 165 patients underwent appendectomy in specified duration. CT scan was found to be 100% specific and 91.4% sensitive in diagnosing appendicitis while clinical diagnosis was accurate in 88.5% cases.