ACCURACY OF ULTRASOUND IN THE DETECTION OF APPENDICITIS

Ultrasound (US) is the preferred first-line imaging modality for diagnosing in acute appendicitis. The published sensitivity and specificity of ultrasonography are higher than the results observed by clinicians in everyday practice. The aim of this study was to elucidate the real-world value of ultrasonography in the diagnosis of appendicitis and its impact on negative appendectomy rates. This prospective study took place in the Department of Radiology at Ajalla Hospital in Benghazi, Libya, over 8 months. The study included 350 cases of clinically suspected appendicitis diagnosed using ultrasonography. All patients were evaluated clinically and underwent imaging, with findings confirmed by perioperative and histopathological results. A total of 350 cases of appendicular pathologies were studied, with a mean patient age of 31.50 (±13.40) years, ranging from 7 to 40 years. Forty-one percent of patients were aged 20-30 years, with 53% females and 47% males. The most common finding was a classical inflamed appendix (34%). The second most common finding was a distended, uncompressed cecum (28%), with other findings including focal dilated terminal ileum, free fluid in the ileocecal region with focal dilation, and free fluid in the ileocecal region, accounting for 17%, 11%, and 10% of cases, respectively. All operated cases were confirmed to have appendicitis on histopathological examination. It can be concluded that ultrasound assessment of the appendix is very accurate in diagnosis, with additional advantages over other radiological imaging techniques such as wide availability, simplicity, low cost, noninvasiveness, and lack of the need for ionizing contrast material. Furthermore, ultrasound can help exclude other causes of right iliac fossa pain.