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.

Volume : VII, Issue : IV, April - 2018

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

Background Appendicitis is a common problem in Indian scenario speci􀃶cally I children upto 14 years. Often they

present in the OPDs as pain abdomen with or without vomiting and fever. Generally in most health centers either

primary, secondary or tertiary the investigation of choice is Ultrasonography. Though the investigation is fairly capable of detecting

Appendicitis or an in􀃸amed appendix in majority there are enough instances where it fails to pick up the in􀃸amed appendix. Keeping this

gap in mind we in the radiology department decided to track coming pediatric population with suspected appendicitis for determining the

efficacy of Ultrasonography for diagnosing Appendicitis

Methodology the present cross sectional observational study was done over a period of six months starting from Jan 2017 to June 2017 in

the radiology department. A total of 128 cases were included. All suspected cases for appendicitis were included after consent from the

parents. Cases who were not willing to participate and who were not admitted were excluded from the study. Once the USG was done

patients, were tracked for the 􀃶nal outcome be it Surgery /Discharge or clinical con􀃶rmation based on the Discharge ticket. Axial Diameters

largest >6mm on USG were considered to be diagnosed as Appendicitis .The 􀃶ndings thus found were compared with surgical and

pathological 􀃶ndings and in cases where there was no surgery Discharge diagnoses was taken as the 􀃶nal diagnosis.

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)

,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

96.67 % ( 95% CI 88.67% to 99.08%) accuracy 89.16% ( 95% CI 80.41% to 94.92%) .

Conclusion With a fairly high accuracy Ultrasonography is choice of imaging for pediatric population presenting with suspected

appendicitis and can help in preventing the morbidity due to appendicitis in children.