DIAGNOSTIC ACCURACY OF COMPUTED TOMOGRAPHY FOR ACUTE APPENDICITIS KEEPING HISTOPATHOLOGY AS GOLD STANDARD

Introduction: Appendix is a small pouch attached to the beginning of large intestine. Appendicitis, an inflammation of the appendix, is the most common acute surgical condition of the abdomen. Almost 10% of the general population develops acute appendicitis with maximal incidence in the second and third decades of life. Objective: To determine diagnostic accuracy of computed tomography in the diagnosis of acute appendicitis keeping histopathology as a gold standard.

Materials and Methods: This study was conducted in the in the Services Hospital Lahore during 2018-19, a total of 191 patients suspected of having acute appendicitis were included in the study in a consecutive manner and subjected to CT pre operatively and histopathology post operatively for the acute appendicitis.

Results: The mean age of the patients was 29.5 + 6.7 years. We had 53.4% males & 46.6% females. On CT we observed that the acute appendicitis was recorded in 58.1% of patients compared to 47.6% on histopathology. On applying the formulae for calculation, sensitivity of CT was found to be 89% and specificity 70%. The positive predictive value of the CT is 72.9% and negative predictive value is 87.5%.

Conclusion: CT is a highly sensitive and specific tool for the detection of acute appendicitis. As such, it is a useful radiological marker for diagnosis of acute appendicitis in adults and further studies are recommended to confirm its usefulness.

Key Words: Acute appendicitis, computed tomography, total leucocyte count, ultrasound, histopathology