Comparison of Preoperative Ultrasonography and Pathology Results of Patients Undergoing Appendectomy

It is still difficult to make the diagnosis of acute appendicitis in children with only clinical examination. The present study, retrospectively reviewing the data of the patients that underwent appendectomy, aimed at emphasizing the diagnostic value of ultrasonography findings by comparing them with pathological diagnosis. This retrospective study included patients aged under 18, who were operated on for appendicitis between 1 January 2015 and 31 December 2015. The relationship between the pathology results of these patients and the results of preoperative ultrasonography performed for the diagnosis of acute appendicitis was investigated. The study included 100 patients, 42 were female and 58 were male, on whom ultrasonography was performed and whose mean age was 11.3 ± 3.7 years. While there were 28 (28%) patients who did not receive a definitive diagnosis of appendicitis pathologically, there were 43 (43%) patients in whom there were no ultrasonography findings supporting appendicitis. While appendicitis diagnosis was made pathologically in 72 patients (72%), suggestive findings of appendicitis, such as compression and double wall thickness of the appendix (over 6 mm), were detected in 57 patients (57%). In addition, 42% periappendiceal fluid collection, 25% periappendiceal fat inflammation, and 14% appendicolith were detected by ultrasonography. While 47 (65.3%) of the 72 patients with pathologically confirmed appendicitis received appendicitis diagnosis by ultrasonography, 25 (34.7%) did not (Pearson square test P = 0.007). The sensitivity and specificity of ultrasonography in the diagnosis of appendicitis were 66.6% (48/72) and 64.28% (18/28), respectively. According to the results of the current study, ultrasonography, in the diagnosis of appendicitis, should only be used for the support of clinical diagnosis or for differential diagnosis.