Elenza Jose, Priyanka Belaguthi and Sumit Midya
Frimley Park Hospital, UK
Scientific Tracks Abstracts: Gen Med (Los Angeles)
Introduction: Acute appendicitis is the most common abdominal pathology we encounter from the admissions in ED. An accurate and timely diagnosis is essential to prevent any complication from delayed surgical intervention. Over the years, imaging modalities have advanced incredibly, and abdominal Ultrasound (US), Computed Tomography (CT) is majorly used in the identification of acute appendicitis. The US's sensitivity and specificity in identifying this have been reported to range from 71 to 92% and 83% respectively, for normal contrastenhanced CT 98 and 91%. Aim: We have audited the diagnostic accuracy of ultrasound and CT reporting in acute appendicitis patients who underwent appendicectomy in Frimley Park Hospital and compared it with the histopathology results. Methods: A retrospective study was conducted, of 100 patients who underwent laparoscopic/open appendicectomy, those who had imaging modality such as ultrasound or CT were included, and we then correlated with their respective histopathology to compare. RCR Audit Live template was used to assess the performance of diagnostic accuracy in our local hospital; The RCR standards for the CT sensitivity should be >90% and for US it should be >70% and paediatric age group should be >85%. Results: Among retrospective analysis of 100 patients who underwent appendicectomy reflected 42 had ultrasound scan, 39 had CT abdomen and pelvis, 2 of them had MRI and 17 patients did not have any scans. The sensitivity of CT scan in diagnosing appendicitis was found to be 100%. Whereas this was 89.4 and 88.3% among ultrasound scans of Child and Adult sub-category respectively. The Positive Predictive value for CT, US (child) and US (Adult) is 88.8, 80.95 and 100% in respective order. There were 11.11% negative Appendicectomy rates with CT scan. This was 19.04% and 0% in the ultrasounds scan of <18 and >18 age group. Conclusion: To summarize, in our institute a high level of diagnostic accuracy was demonstrated when utilizing CT to diagnose cases of acute appendicitis. Also, the criteria for sensitivity for Ultrasound scan were met successfully.
Elenza Jose is working in Frimley Park Hospital Frimley, UK. Priyanka Belaguthi is working in Frimley Park Hospital Frimley, UK. Sumit Midya is working in Frimley Park Hospital Frimley, UK.
