caa a22 4500 606247459 CHVBK 20210128101345.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s12262-012-0772-5 doi (NATIONALLICENCE)springer-10.1007/s12262-012-0772-5 On the Role of Ultrasonography and CT Scan in the Diagnosis of Acute Appendicitis [Elektronische Daten] [Jyotindu Debnath, Rajesh Kumar, Ankit Mathur, Pawan Sharma, Nikhilesh Kumar, Nagaraj Shridhar, Ashwani Shukla, Shiv Khanna] The purposes of this study were to revisit the utility of ultrasonography (USG) as a primary imaging modality in acute appendicitis (AA) and to establish the role of CT scan as a second-line/problem-solving modality. All cases of suspected AA were referred for urgent USG. USG was done with standard protocol for appendicitis. Limited computed tomographic (CT) scan [NCCT ± CECT (IV contrast only)] was done for the lower abdomen and pelvis where sonographic findings were equivocal. One hundred and twenty-one patients were referred for USG for suspected appendicitis. Eight-four patients underwent surgery for AA based on clinical as well as imaging findings, of whom 76 had appendicitis confirmed at histopathology. Three patients were misdiagnosed (3.6%) on USG as appendicitis. Of 76 patients of appendicitis confirmed histopathologically, 63 (82.8%) had features of appendicitis on USG and did not require any additional imaging modality. Of 121 patients, 12 (10%) needed CT scan because of atypical features on USG. Of these 12 patients, seven had retrocecal appendicitis, and three high-up paracolic appendicitis. USG alone had sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 81, 88, 92.6, 71.6, and 83%, respectively. When combined with CT scan in select cases, the sensitivity, specificity, PPV, NPV, and accuracy of combined USG + CT scan were 96% (P = 0.0014), 89%, 93%, 93.5% (P = 0.0001), and 93% (P = 0.0484), respectively. Twenty-eight (23%) patients were given alternative diagnosis on USG. Dedicated appendiceal USG should be used as a primary imaging modality in diagnosing or excluding AA. Appendiceal CT can serve as a problem-solving modality. Association of Surgeons of India, 2012 Appendicitis nationallicence Ultrasonography nationallicence CT scan nationallicence Debnath Jyotindu Department of Radiology, Armed Forces Medical College, 411 040, Pune, Maharashtra, India aut Kumar Rajesh Department of Surgery, 151 Base Hospital, Guwahati, India aut Mathur Ankit Department of Radiodiagnosis and Imaging, 167 Military Hospital, 145001, Pathankot, Punjab, India aut Sharma Pawan Department of Surgery, 167 Military Hospital, Pathankot, India aut Kumar Nikhilesh Pathology, 167 Military Hospital, Pathankot, India aut Shridhar Nagaraj Anesthesiology, 167 Military Hospital, Pathankot, India aut Shukla Ashwani Department of Surgery, Military Hospital, Dehradun, India aut Khanna Shiv Pathology, 167 Military Hospital, Pathankot, India aut Indian Journal of Surgery Springer India 77(2015-12-01), 221-226 0972-2068 77<221 2015 77 12262 https://doi.org/10.1007/s12262-012-0772-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s12262-012-0772-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Debnath Jyotindu Department of Radiology, Armed Forces Medical College, 411 040, Pune, Maharashtra, India aut NATIONALLICENCE 700 1- Kumar Rajesh Department of Surgery, 151 Base Hospital, Guwahati, India aut NATIONALLICENCE 700 1- Mathur Ankit Department of Radiodiagnosis and Imaging, 167 Military Hospital, 145001, Pathankot, Punjab, India aut NATIONALLICENCE 700 1- Sharma Pawan Department of Surgery, 167 Military Hospital, Pathankot, India aut NATIONALLICENCE 700 1- Kumar Nikhilesh Pathology, 167 Military Hospital, Pathankot, India aut NATIONALLICENCE 700 1- Shridhar Nagaraj Anesthesiology, 167 Military Hospital, Pathankot, India aut NATIONALLICENCE 700 1- Shukla Ashwani Department of Surgery, Military Hospital, Dehradun, India aut NATIONALLICENCE 700 1- Khanna Shiv Pathology, 167 Military Hospital, Pathankot, India aut NATIONALLICENCE 773 0- Indian Journal of Surgery Springer India 77(2015-12-01), 221-226 0972-2068 77<221 2015 77 12262