Clinical Study for Efficacy of Different Diagnostic Tools for the Diagnosis of Acute Appendicitis

Introduction: Acute Appendicitis (AA) is one of the most common causes of surgical abdominal pain and can be confused with other diseases due to atypical presentations of the disease. So, to aid in the diagnosis the various scoring systems and radiochemical investigations are in use such as Modified...

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Main Authors: Ranendra Hajong, Narang Naku, Malaya Ranjan Dhal, Manash Pratim Boruah, Ojing Komut, Arup Jyoti Baruah, Donkupar Khongwar, Girish Sharma
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2018-04-01
Series:Journal of Clinical and Diagnostic Research
Subjects:
Online Access:https://jcdr.net/articles/PDF/11380/32610_F(SHU)_PF1(BT_MSL_RA_SL)_PFA(BT_SL)_PB(BT_SL)_PN(SL).pdf
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author Ranendra Hajong
Narang Naku
Malaya Ranjan Dhal
Manash Pratim Boruah
Ojing Komut
Arup Jyoti Baruah
Donkupar Khongwar
Girish Sharma
author_facet Ranendra Hajong
Narang Naku
Malaya Ranjan Dhal
Manash Pratim Boruah
Ojing Komut
Arup Jyoti Baruah
Donkupar Khongwar
Girish Sharma
author_sort Ranendra Hajong
collection DOAJ
description Introduction: Acute Appendicitis (AA) is one of the most common causes of surgical abdominal pain and can be confused with other diseases due to atypical presentations of the disease. So, to aid in the diagnosis the various scoring systems and radiochemical investigations are in use such as Modified Alvarado Score (MAS), Ultrasonography (USG) of abdomen, Computed Tomography (CT) scan of abdomen and serum bilirubin levels. Aim: To study the diagnostic efficacy of MAS, USG of abdomen, CT scan of abdomen and serum bilirubin level for the diagnosis of AA. Materials and Methods: This was a prospective observational study conducted in the North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India. A total of 72 patients with the clinical diagnosis of AA participated in the study. The patients were subjected to MAS, USG of abdomen; serum bilirubin level and Contrast-Enhanced Computed Tomography (CECT) scan on admission. Sensitivity, specificity, positive predictive value and negative predictive value for each test were found. Final diagnosis was confirmed histopathologically. Descriptive statistics data were calculated using SPSS version 22.0. Results: Sensitivity was highest for USG 42 (80.77%) out of 52. Specificity was highest for CT scan 18 (90%) out of 20, when target sign was found positive in the patient and also in cases of serum bilirubin 18 (90%) out of 20 when the patient had perforated appendicitis. Otherwise the overall diagnostic accuracy of USG was the highest 47 (65.28%) of 72. Conclusion: Diagnosis of AA is still challenging as the overall sensitivity or specificity of scoring system as well as radiochemical analysis is still very poor.
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spelling doaj.art-4d4152ba39e1412a982af10d75552d1c2022-12-21T19:24:40ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2018-04-01124PC01PC0410.7860/JCDR/2018/32610.11380Clinical Study for Efficacy of Different Diagnostic Tools for the Diagnosis of Acute AppendicitisRanendra Hajong0Narang Naku1Malaya Ranjan Dhal2Manash Pratim Boruah3Ojing Komut4Arup Jyoti Baruah5Donkupar Khongwar6Girish Sharma7Associate Professor, Department of General Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.Resident, Department of General Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.Resident, Department of General Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.Resident, Department of General Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.Assistant Professor, Department of General Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.Associate Professor, Department of General Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.Assistant Professor, Department of General Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.Resident, Department of General Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.Introduction: Acute Appendicitis (AA) is one of the most common causes of surgical abdominal pain and can be confused with other diseases due to atypical presentations of the disease. So, to aid in the diagnosis the various scoring systems and radiochemical investigations are in use such as Modified Alvarado Score (MAS), Ultrasonography (USG) of abdomen, Computed Tomography (CT) scan of abdomen and serum bilirubin levels. Aim: To study the diagnostic efficacy of MAS, USG of abdomen, CT scan of abdomen and serum bilirubin level for the diagnosis of AA. Materials and Methods: This was a prospective observational study conducted in the North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India. A total of 72 patients with the clinical diagnosis of AA participated in the study. The patients were subjected to MAS, USG of abdomen; serum bilirubin level and Contrast-Enhanced Computed Tomography (CECT) scan on admission. Sensitivity, specificity, positive predictive value and negative predictive value for each test were found. Final diagnosis was confirmed histopathologically. Descriptive statistics data were calculated using SPSS version 22.0. Results: Sensitivity was highest for USG 42 (80.77%) out of 52. Specificity was highest for CT scan 18 (90%) out of 20, when target sign was found positive in the patient and also in cases of serum bilirubin 18 (90%) out of 20 when the patient had perforated appendicitis. Otherwise the overall diagnostic accuracy of USG was the highest 47 (65.28%) of 72. Conclusion: Diagnosis of AA is still challenging as the overall sensitivity or specificity of scoring system as well as radiochemical analysis is still very poor.https://jcdr.net/articles/PDF/11380/32610_F(SHU)_PF1(BT_MSL_RA_SL)_PFA(BT_SL)_PB(BT_SL)_PN(SL).pdfmodified alvarado scoreserum bilirubinultrasonography of abdomen
spellingShingle Ranendra Hajong
Narang Naku
Malaya Ranjan Dhal
Manash Pratim Boruah
Ojing Komut
Arup Jyoti Baruah
Donkupar Khongwar
Girish Sharma
Clinical Study for Efficacy of Different Diagnostic Tools for the Diagnosis of Acute Appendicitis
Journal of Clinical and Diagnostic Research
modified alvarado score
serum bilirubin
ultrasonography of abdomen
title Clinical Study for Efficacy of Different Diagnostic Tools for the Diagnosis of Acute Appendicitis
title_full Clinical Study for Efficacy of Different Diagnostic Tools for the Diagnosis of Acute Appendicitis
title_fullStr Clinical Study for Efficacy of Different Diagnostic Tools for the Diagnosis of Acute Appendicitis
title_full_unstemmed Clinical Study for Efficacy of Different Diagnostic Tools for the Diagnosis of Acute Appendicitis
title_short Clinical Study for Efficacy of Different Diagnostic Tools for the Diagnosis of Acute Appendicitis
title_sort clinical study for efficacy of different diagnostic tools for the diagnosis of acute appendicitis
topic modified alvarado score
serum bilirubin
ultrasonography of abdomen
url https://jcdr.net/articles/PDF/11380/32610_F(SHU)_PF1(BT_MSL_RA_SL)_PFA(BT_SL)_PB(BT_SL)_PN(SL).pdf
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