Diagnosis of acute appendicitis : a comparison of the efficacy of clinical signs and symptoms and laboratory investigations

Abstract EN

Objectives : The purpose of the study was to compare the validity of clinical presentations and laboratory tests in the diagnosis of acute appendicitis, the major cause of emergency surgical procedures.

Methods: A total of200 patients with suspected acute appendicitis who underwent surgery were included in the study.

Clinical history, detailed physical examination, and laboratory investigations were reviewed.

The postoperative findings were obtained directly from the operating surgeon.

Results: In this group, 69% had acute appendicitis, 9% had acute appendicitis with complications, and the remaining 22% had normal appendices.

Right iliac fossa pain, nausea and vomiting were sensitive but not specific symptoms.

Tachycardia, hypotension, and fever were of low sensitivity but high specificity.

Tenderness in the right iliac fossa and rebound tenderness were highly sensitive but not specific.

The WBC count was a sensitive test in the diagnosis of acute appendicitis in comparison with ultrasound examination, which showed a low sensitivity.

General urine examination was not valuable in the diagnosis.

Conclusion : Acute appendicitis is a condition, which requires immediate treatment.

The use of highly sensitive tests with high positive predictive value, though of low specificity, favors the appropriate diagnosis and treatment and minimizes the risk of missing cases.