Khalid Rehman Yousaf, Salman Atiq, Saira Bilal, Mian Sajid Nisar, Ismail M, Khalid Yousaf, Muhammad Ghias.
Emergency based ultrasound of clinically suspected acute appendicitis with low frequency curvilinear transducer and its association with surgical outcome.
Pak J Med Health Sci Jan ;5(2):361-4.

Aim: To determine the diagnostic accuracy of low frequency curvilinear transducer as an ancillary emergency tool for clinical suspects of acute appendicitis and its association with surgical outcome. Material & methods: This cross sectional study was conducted at Omer hospital between September 2008 and December 2010. We included 89 cases (38 male, 51 female; age range 12–70 years, mean age 37 years) of clinically suspected acute appendicitis. Clinical categorization was based on Alvarado scoring. Transabdominal ultrasound was performed using curvilinear low frequency 3.5-MHz transducer with graded compression technique, followed by linear high frequency transducer of 7.5MHz. All cases underwent appendectomy. Specimen inflammatory grading was done by histopathology. Results: Out of 89 patients, 71 cases presented with typical and 18 with atypical clinical symptoms and signs of acute appendicitis. On sonography, appendix was visualized in 73 cases (82%) using low frequency transducer in comparison to 78 cases (87.6%) by high frequency transducer. Sensitivity and specificity of preoperative sonographic scan was about 68.0% and 88.0% respectively. Association of sonographic and histopathological diagnostic evidences was also found statistically significant (p=0.000). Conclusion: Negative appendectomy rate can be substantially reduced by a careful ultrasound examination using low frequency transducer, which proves ancillary to clinical evaluation.

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