Acute appendicitis is the most common cause of acute surgical abdomen and appendicectomy is the most commonly done emergency surgery. Its diagnosis remains an enigmatic challenge, plagued by a high rate of negative explorations. There is no single reliable test with satisfactory, sensitivity and specificity.
Aim and Objective: The objective of the study is to evaluate the clinical presentations, signs of acute appendicitis and its management. The role of USG in diagnosing acute appendicitis and reducing the rate of negative appendicectomies.
Methodology: The present study was conducted in 100 patients who have been clinically diagnosed of having Acute Appendicitis and posted for emergency appendicectomy in General Surgery, Department of MGM, attached to Kakatiya Medical College, Warangal, during the period from January 2018 to June 2020. Preoperatively blood for WBC count, DC and USG abdomen were done. All patients were subjected to histopathological examination postoperatively which was taken as gold standard. Results of Ultrasound were correlated with HPE reports to evaluate their role in diagnosis of acute appendicitis.
Results and Observations: In the present study we had 100 cases of which 61 (61%) were males and 39 (39%) were females. The number of patients was highest in the age group 20 to 29years (33%). Migrating Pain to RIF was found in 76% of patients, Anorexia in 87% of patients. Nausea/vomiting were present in 79% patients. Right iliac fossa tenderness was found in 98% of cases. Rebound tenderness was found in 68% of patients. Fever was present in 45% of cases. Total leucocyte count was elevated in 80% of cases in our present study. Shift to let was seen in 42% cases. In our study all the patients were subjected to abdominal ultrasound examination. The sensitivity and specificity of Ultrasonography for acute appendicitis is 94.8% and 80% respectively. Accuracy was 93%. The positive predictive value and negative predictive value of Ultrasonography for acute appendicitis is 98% and 44% respectively. Negative appendectomy rate in this study 5.5%.The majority (60%) is seen in females.
Conclusion: Ultrasound is a fast, simple, reliable, non-invasive, repeatable and safe diagnostic modality without any complications. It has greater sensitivity and positive predictive value in diagnosing acute appendicitis and it reduces the rate of negative appendicectomy.