Role of Ultrasound Imaging In the Diagnosis of Acute Appendicitis and Its Importance in the Decision of the Emergency Appendectomy Operation: A Prospective Study in Jawaharlal Nehru Institute of Medical Sciences, Porompat, Manipur
Background: Appendicitis is the most common abdominal emergency need early intervention. Although the proper clinical examination with the necessary laboratory findings is only the mainstay for the diagnosis, further ultrasonography (USG) investigation will give more detail information for a definitive diagnosis. The patients with right iliac fossa (RIF) pain suspecting appendicitis clinically attended in Jawaharlal Nehru Institute of Medical Sciences, Porompat, Manipur (JNIMS), were further examined by USG in the Department of Radiodiagnosis, JNIMS for a definitive diagnosis and further line of management. Aim and Objective: The role of USG in the RIF pain for a definitive diagnosis of appendicular pathology as well as the other abdominal and pelvic disorder is the aim and objectives of the paper. Study Design: This was an observational study. Setting: This study was conducted at JNIMS, Porompat, Manipur. Materials and Methods: A total of 300 suspected appendicitis admitted in the Department of Surgery, JNIMS, Unit-1 were examined in the Department of Radiodiagnosis, JNIMS by USG with the convex probe 3.5 MHz and linear probe of 7.5 MHz, from March 1, 2015, to February 28, 2017. Age of patients belongs to 10–80 years, irrespective of sex and race. All are examined by USG (high-frequency linear probe, 7.5 MHz) to assess appendicular morphology and pathology along with a thorough abdominal examination for the other non-appendicular causes. Appendectomy operation was performed accordingly in JNIMS. The operative findings were correlated with the clinical diagnosis and USG findings and were analyzed. Result: Out of 300 patients only 256 patients were confirmed appendicitis by the USG and 44 patients were non-appendicular pathology (right ureteric stone including right ureterovesical junction calculus-13, pelvic inflammatory disease diagnosed by trans vaginal USG-16, and other GIT cause other than the urology and gynecological causes-15). The patients who were diagnosed with USG findings as appendicitis of varying degree counseled and took consent for the operation. Conclusion: Clinical diagnosis of appendicitis needs USG evaluation to increase the diagnostic accuracy and also to avoid the negative laparotomy.