Evaluation of Negative Appendectomy Rate with Preoperative Computed Tomography and Ultrasonography | ||||
| Al-Azhar International Medical Journal | ||||
| Volume 2023, Issue 1, January 2023 | ||||
| DOI: 10.58675/2682-339X.1701 | ||||
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| Authors | ||||
| Mohamed Sobhy Teamah; Abdel Fattah Morsi saeid Mohamed; Hany Mohammed Ahmed Morsi | ||||
| Department of General Surgery, Faculty of Medicine for boys, Al-Azhar University, Cairo, Egypt. | ||||
| Abstract | ||||
| Background: The most prevalent diagnosis needing urgent surgery is acute appendicitis, and patients are usually treated by young physicians. Aim and objectives: to ascertain the use of preoperative computed CT and US in the examination of patients with suspected acute appendicitis and to ascertain if variations in CT usage were related to variations in the negative appendectomy rate. Subjects and methods: This prospective research was carried out on 100 patients with suspected acute appendicitis from emergency room of Al-Azhar university hospitals. All the studied patients were subjected to the following: demographic data, lab investigation, the Alvarado score, Radiological investigation including US and CT. Results: With US examination 11 (73.33%) cases were truly diagnosed normal and 80 (91.12%) cases were truly diagnosed abnormal. With CT examination 13 (86.67%) were truly diagnosed normal and 83 (97.65%) were truly diagnosed abnormal. US sensitivity, specificity, PPV and NPV reached 94.1%, 73.3%, 95.2% and 68.8%. CT sensitivity, specificity, PPV and NPV reached 97.6%, 86.7%, 97.6% and 86.7%. Diagnosis with US and CT together sensitivity, specificity, PPV and NPV reached 94.1%, 86.7%, 97.6% and 72.2%. Diagnosis with CT or US sensitivity, specificity, PPV and NPV reached 97.6%, 73.3%, 95.4% and 84.6%. Conclusion: The primary disadvantage of CT is that it exposes patients to ionizing radiation, which is especially dangerous for pregnant and young patients. The cost of CT is also higher than in the US, and the risk of an allergic response to the contrast medium is modest but significant. | ||||
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