Vol. 9, Issue 7, Part E (2023)

To evaluate the accuracy of CT in identifying appendicitis in ultrasound negative cases.

To assess the efficacy of CT in identifying complications of appendicitis.

To identify the alternate diagnosis of right lower quadrant pain which mimic appendicitis.

To determine the average CT thickness of normal appendix in Indian population by measuring the appendix diameter in CT abdomen for other cases.

Methodology: Patients who were admitted within the casualty surgical emergency ward inside the cohort of age 12-55 bestowed with clinical findings and symptoms of acute inflammation like right iliac fossa pain, fever and vomiting were listed within the study. A complete study sample of two hundred was chosen. The clinical history concerning present history was taken within the prescribed proforma.

Informed consent was obtained from every taking part patient and also the protocol was approved by the institutional ethical committee. 64 Patients with negative ultrasound findings or with equivocal findings were proceed with CT examination and results were obtained.

Results: The study after statistical analysis brings to the conclusion of: Out of 200 patients in the study population with right lower quadrant pain and negative ultrasound findings, 77 patients were found to have appendicitis based on CT findings. Based on this study, the patients with CT finding of an appendicular diameter of >6mm (7-8mm in particular) were found to have Appendicitis, which was found in accordance with other corroborative findings, intra operative findings and histopathological correlation.

This brings us to the conclusion of CT having a more accurate role in the diagnosis of Appendicitis in patients with negative ultrasound findings with a significant sensitivity, specificity, positive and negative predictive value.

The results of the study among patients with right lower quadrant pain, vomiting, fever and low backache and with equivocal /negative ultrasound findings, CT plays the next imaging modality of choice.

77 cases were found to have appendicitis in CT among the study population of 200. Among which 50 patients i.e. 25 % of cases have appendix diameter of 7-8mm with periappendiceal fat stranding and appendiceal wall enhancement and diagnosed as appendicitis.

Due to retrocaecal position of appendix obscured by gas shadows and obesity lead to non- visualization of appendix, thus giving USG negative picture for diagnosing appendicitis.

CT is the best modality of choice for diagnosing appendicitis with 7-8mm diameter of appendix along with periappendiceal fat stranding and wall enhancement. 7-8 mm diameter of appendix associated with adjacent CT

changes was one of the findings of a major group of patients diagnosed as appendicitis in this study who had negative ultrasound findings.