European Journal of Cardiovascular Medicine

Introduction: Acute appendicitis (AA) is a common abdominal emergency with a lifetime prevalence of about 7 %. As the clinical diagnosis of AA remains a challenge to emergency physicians and surgeons, imaging modalities have gained major importance in the diagnostic work-up of patients with suspected AA in order to keep both the negative appendectomy rate and the perforation rate low. Materials and methods: This is a prospective study was conducted in the Department of Radiology at Dr. VRK Women's Medical College, Teaching Hospital and Research Center Hyderabad, Our standard protocol is that all adult patients suspected of appendicitis receive an ultrasound as their first imaging test, either by an emergency physician or a radiologist. The test characteristics of conclusive and inconclusive ultrasound exams were compared with a pragmatic gold standard. Result: In our study, most of the subjects were 11-15 years i.e., out of 90 (55.55%), followed by 6-10 years, i.e., 39 out of 90 (43.3%). In our study shows that all the cases presented with pain in the right iliac fossa and clinical suspicion of acute appendicitis which were the selection criteria for the present study. Acute appendicitis symptoms were (45.85), right ureteric colic (12.2%), pelvic inflammatory disease (7.7%), ovarian cyst (1.1%) and intestinal ascariasis (1.1%). 30% of cases were inconclusive.  Irrespective of the pathology, vomiting was found to be present in 62.2% of the cases. Murphy’s triad of symptoms i.e. pain in abdomen, vomiting and fever held good in the diagnosis of acute appendicitis in our study. Tenderness in right iliac fossa was the most common sign elicited in all the cases (100%). Conclusion: Ultrasound sensitivity and the rate of visualization of the appendix on US varied across sites and appeared to improve with more frequent use. US had universally high sensitivity and specificity when the appendix was clearly identified. Other diagnostic modalities should be considered when the appendix is not definitively visualized by US