ABDOMINAL SONOGRAPHY SCREENING OF CLINICALLY DIAGNOSED OR SUSPECTED APPENDICITIS BEFORE SURGERY

We conducted a prospective study to evaluate the value of abdominal so nography in the diagnosis of acute appendicitis and determine the need for abdominal sonography before operation, Altogether 191 patients wi th clinically diagnosed or suspected appendicitis underwent an abdomin al sonography examination performed by a staff surgeon before operatio n, The sonographic findings are classified into three categories: appe ndicitis, other diseases, or normal screening. A total of 158 patients (82.7%) with positive findings of appendicitis proceeded to surgery; 18 patients (9.4%) were found to have other diseases, and they were tr eated for their conditions; and 15 patients (7.9%) with normal screeni ng were discharged from the hospital and were reevaluated 2 weeks late r. Only one patient had a false-negative finding, Of the 158 patients undergoing operation, 143 (90.5%) were proved to have appendicitis by the pathologic reports, A total of 32 negative appendectomies (16.8%) were prevented after sonographic examination, Abdominal sonography for detecting acute appendicitis had a sensitivity of 99.3%, a specificit y of 68.1%, an accuracy of 91.6%, a positive predictive value of 90.5% , and a negative predictive value of 97.0%, The value of meticulous hi story-taking, physical examination, and laboratory tests cannot be ove remphasized, Our experience suggests that patients with clinically dia gnosed or suspected acute appendicitis should routinely undergo abdomi nal sonography examination, performed by an experienced surgeon, to fu rther decrease the negative appendectomy rates.