Naveed Muzaffar, Safdar Bhatti.
Negative Appendectomy Rate: the Imaging Impact.
Pak J Med Health Sci Jan ;8(3):734-5.

Aim: To determine the rate of negative appendectomy and evaluating the value of preoperative imaging in reducing this rate. Methods: Our study was carried out in General surgical department of King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia. Study period was from May 2013 to Feb 2014.All patients aged 12 years and above, undergoing emergency appendectomy were included in the study. Incidental appendectomies were excluded. All patients were analyzed in regards to the clinical evaluation, pre operative laboratory investigations, imaging modalities and final histopathology. Results: Total of 100 patients was diagnosed as acute appendicitis and underwent emergency appendectomy. Pre-operative ultrasound (US) and computed tomography (CT) was performed in 48 cases (48%). Sensitivity and specificity of US was 75% and 60% respectively where as both were 100% for CT. The positive and negative prediction value for US was 92.30% and 27.27% respectively in comparison to CT, which had 100% predictive value in either case. Conclusion: We concluded that our rate of negative appendectomy is acceptable and comparable to most studies in literature. Radiological imaging in cases with doubtful diagnosis is of immense value. CT is superior to US in sensitivity and specificity. It also carries better predictive value and should be more frequently used to reduce the rate of negative appendectomies.

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