Volume : 7, Issue : 4, April - 2018

Estimating the sensitivity, specificity and predictive value of Ultrasonography for Suspected Appendicitis in pediatric population, coming for Ultrasonography in Radiology Department of Rajendra Institute of Medical Sciences (RIMS ) in Ranchi Jharkhand.

Dr Paras Nath Ram, Dr Rajeev Kumar Ranjan, Dr Phulak Abhishek, Dr Suresh Kumar Toppo

Abstract :

<p>&nbsp;Background Appendicitis is a common problem in Indian scenario speci􀃶cally I children upto 14 years. Often they</p> <div>present in the OPDs as pain abdomen with or without vomiting and fever. Generally in most health centers either</div> <div>primary, secondary or tertiary the investigation of choice is Ultrasonography. Though the investigation is fairly capable of detecting</div> <div>Appendicitis or an in􀃸amed appendix in majority there are enough instances where it fails to pick up the in􀃸amed appendix. Keeping this</div> <div>gap in mind we in the radiology department decided to track coming pediatric population with suspected appendicitis for determining the</div> <div>efficacy of Ultrasonography for diagnosing Appendicitis</div> <div>Methodology the present cross sectional observational study was done over a period of six months starting from Jan 2017 to June 2017 in</div> <div>the radiology department. A total of 128 cases were included. All suspected cases for appendicitis were included after consent from the</div> <div>parents. Cases who were not willing to participate and who were not admitted were excluded from the study. Once the USG was done</div> <div>patients, were tracked for the 􀃶nal outcome be it Surgery /Discharge or clinical con􀃶rmation based on the Discharge ticket. Axial Diameters</div> <div>largest &gt;6mm on USG were considered to be diagnosed as Appendicitis .The 􀃶ndings thus found were compared with surgical and</div> <div>pathological 􀃶ndings and in cases where there was no surgery Discharge diagnoses was taken as the 􀃶nal diagnosis.</div> <div>Results Appendix was identi􀃶ed in 65% (83)/128 of suspected cases . The overall sensitivity was 88.89% ( 95% CI 65.29% to 98.62)</div> <div>,speci􀃶city 89.23 % (95% CI 79.06% to 95.56%) , Positive Predictive Value 69.57% ( 95% CI 52.70% to 82.42% ) , negative predictive value</div> <div>96.67 % ( 95% CI 88.67% to 99.08%) accuracy 89.16% ( 95% CI 80.41% to 94.92%) .</div> <div>Conclusion With a fairly high accuracy Ultrasonography is choice of imaging for pediatric population presenting with suspected</div> <div>appendicitis and can help in preventing the morbidity due to appendicitis in children.</div>