The Relationship between Ultrasound and Intra-operative Findings of Appendicitis in Saint Paul’s Hospital, Addis Ababa Ethiopia

Abstract

Abstract Background: Appendicitis is one of the most common causes of acute abdomen in the world including Ethiopia. Appendicitis is the inflammation of the vermiform appendix which is located in the right lower quadrant on the posteromedial wall of the cecum. It might be complicated or simple. Complicated appendicitis is appendicitis in the presence of gangrene, perforation or abscess around the inflamed appendix whereas simple appendicitis refers to appendicitis in the absence of perforation, gangrene or peri-appendicular abscesses. Being the common cause of acute abdomen knowing the potential pitfalls in ultrasound diagnosis of appendicitis is crucial for patient management. Aims: The main aim of this study is to determine the relationship between ultrasound and intra operative findings of appendicitis in Saint Paul’s Hospital. Methodology: A cross sectional study design was conducted in Saint Paul’s Hospital and the data was extracted from patients’ charts. A simple random sample of 233 patients was involved. To collect the necessary data, a structured checklist was prepared and the data was collected by trained data collectors. Then, the data is entered, and analyzed by using SPSS statistical software. In the analysis, the sensitivity of the ultrasound was determined including its 95% confidence interval. In addition, the relationship between the ultrasound and intra-operative findings is determined using a multinomial logistic regression. Ethical clearance has been secured from SPHMMC department of radiology. Result: Appendicitis is found to be common in adolescents and adults than other age groups and males more common than females with male: female of 1.79:1. Among 209 patients who undergo appendectomy the overall sensitivity of ultrasound in diagnosing appendicitis is about 94.7%. The ultrasound finding of simple appendicitis corresponds to 60.5% of patients who have simple appendicitis intraoperatively. Appendiceal diameter of >10mm is seen in more than 60% of patients who have phlegmonous and gangrenous appendix intraoperatively. Conclusion and recommendation: ultrasound can make diagnosis of acute appendicitis with high specificity. Despite we need other parameters appendiceal diameter of more than 10 mm can predict possibility of having phlegmonous and gangrenous appendicitis. Further prospective study is recommended to prove this finding in the study.