Clinico-sonological and histopathology findings in patients with right iliac fossa pain who underwent appendectomy: a retrospective observational study in a tertiary care hospital

Authors

  • Kumar Lakshman Department of Neurosurgery, Adichunchanagiri Institute of Medical Sciences, B G Nagara, Karnataka, India
  • Shilpashree Channasandra Shekar Department of General Surgery, Mandya Institute of Medical Sciences, Mandya, Karnataka, India
  • Naveen Narayan Department of Plastic and Reconstructive Surgery, Adichunchanagiri Institute of Medical Sciences, B G Nagara, Karnataka, India http://orcid.org/0000-0001-7125-5842
  • Suhas Narayana Swamy Gowda Department of General Surgery, Adichunchanagiri Institute of Medical Sciences, B G Nagara, Karnataka, India
  • Pallavi Hosadurga Raghavendra Department of General Surgery, Adichunchanagiri Institute of Medical Sciences, B G Nagara, Karnataka, India
  • Rakshitha Janardan Department of General Surgery, Adichunchanagiri Institute of Medical Sciences, B G Nagara, Karnataka, India
  • Shantala Singh Department of General Surgery, Adichunchanagiri Institute of Medical Sciences, B G Nagara, Karnataka, India

DOI:

https://doi.org/10.18203/2349-2902.isj20220327

Keywords:

Acute appendicitis, Chronic appendicitis, Radiological findings, Histopathological findings

Abstract

Background: Appendicitis being the one the most common cause of right iliac fossa pain that leads to emergency abdominal surgery. The existence of non-perforating or non-acute forms of appendicitis is doubted to this day despite clinical, intraoperative, radiological and histo-pathological findings. Appendectomy though being curative, yet the decision on its timing is still controversial especially in non-acute variants of appendicitis.

Methods: A retrospective observational study on 200 consecutive cases of suspected appendicitis who underwent appendectomy in department of General surgery, Adichunchangiri Hospital and Research Centre during a period between January 2020 and January 2021. The data was accrued from patient data base retrospectively and analysed.

Results: We found in our study that the ultrasonographic findings had a sensitivity of 100% and a specificity of 44.44% as compared to the clinical diagnosis of appendicitis. The histopathological studies revealed chronic inflammatory cells in 63% of the resected specimens, suggestive of chronic appendicitis and acute inflammatory cells in 37% of the specimens, suggestive of acute appendicitis.

Conclusions: We conclude that the clinical findings, ultrasonological findings and the histopathological findings correlate with one another (p<0.001). The diagnostic accuracy of ultrasonogram was reported to range from 71 to 97% when used in the right setting (acute forms) and it is user dependent. When clinical findings compliments radiology, the existence and diagnostic accuracy of such conditions (acute and non-acute) increase drastically and can be confirmed on histopathology.

Author Biographies

Kumar Lakshman, Department of Neurosurgery, Adichunchanagiri Institute of Medical Sciences, B G Nagara, Karnataka, India

Assistant Professor, Department of Neurosurgery

Shilpashree Channasandra Shekar, Department of General Surgery, Mandya Institute of Medical Sciences, Mandya, Karnataka, India

Senior Resident, Department of General Surgery

Naveen Narayan, Department of Plastic and Reconstructive Surgery, Adichunchanagiri Institute of Medical Sciences, B G Nagara, Karnataka, India

Associate Professor, Department of Plastic & Reconstructive Surgery

Suhas Narayana Swamy Gowda, Department of General Surgery, Adichunchanagiri Institute of Medical Sciences, B G Nagara, Karnataka, India

Assistant Professor, Department of General Surgery

Pallavi Hosadurga Raghavendra, Department of General Surgery, Adichunchanagiri Institute of Medical Sciences, B G Nagara, Karnataka, India

Post Graduate, Department of General Surgery

Rakshitha Janardan, Department of General Surgery, Adichunchanagiri Institute of Medical Sciences, B G Nagara, Karnataka, India

Post Graduate, Department of General Surgery

Shantala Singh, Department of General Surgery, Adichunchanagiri Institute of Medical Sciences, B G Nagara, Karnataka, India

Post Graduate, Department of General Surgery

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Published

2022-01-29

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Original Research Articles