Evaluating the Diagnostic Efficacy of Computed Tomography in Appendicitis Cases With Negative Ultrasound Findings

Introduction: Acute appendicitis (AA) is a prevalent cause of abdominal pain, and accurate diagnosis is critical to prevent complications such as perforation. While ultrasound (USG) is often the first imaging modality, its limitations necessitate alternative approaches, particularly in cases where USG results are negative.

Objectives and aims: This study aims to evaluate the diagnostic accuracy of computed tomography (CT) in identifying appendicitis in patients presenting with negative USG findings.

Materials and methods: A prospective observational study was conducted at a tertiary care hospital in Pondicherry, India, involving 70 patients with clinically suspected appendicitis and negative USG results. All patients underwent CT imaging, and findings were analyzed to determine sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy.

Results: Of the 70 patients, 35 were diagnosed with appendicitis based on CT findings, yielding a sensitivity of 100%, a specificity of 65.71%, a PPV of 74.47%, an NPV of 100%, and an overall accuracy of 82.86%. The study also identified other conditions, such as mesenteric lymphadenitis and ureteric calculus, in patients with negative appendicitis diagnoses.

Conclusions: CT is a highly effective imaging modality for diagnosing appendicitis in patients with negative USG results. The use of CT significantly aids in clinical decision-making, reducing the rates of unnecessary surgeries and complications.