Effect of surgeon’s judgement on the diagnosis of acute appendicitis
Mustafa Hasbahçeci1, Cengiz Erol2, Mustafa Törü3, Mehmet Şeker4
1Department of General Surgery, Faculty of Medicine, Bezmialem Vakıf University, İstanbul, Turkey
2Department of Radiology, Faculty of Medicine, İstanbul Medipol University, İstanbul, Turkey
3Department of Radiology, 29 Mayıs Hospital, Ankara, Turkey
4Department of Radiology, 29 Mayıs Hospital, İstanbul, Turkey
Abstract
Objective: The accuracy of a surgeon’s judgement still remains to be controversial in the diagnosis of acute appendicitis, which is a diagnosis usually based on laboratory data and imaging tests.
Material and Methods: Patients with a possible diagnosis of acute appendicitis were reviewed retrospectively with regard to demographic variables, laboratory and imaging results, and treatment modalities.
Results: There were 128 patients with a mean age of 31.2±14 years. The mean white blood cell count and the proportion of polymorphonuclear leukocytes were 11403±4669/mm3 and 75±11%, respectively. Appendectomy was performed on 66 (51.6%) patients. Conservative management was applied to 62 (48.4%) patients. Statistical analysis showed that patients with appendicitis have a higher white blood cell count (p=0.015) and a higher proportion of polymorphonuclear leukocytes (p=0.023). Sensitivity, specificity and accuracy rates were 84.6%, 63.7% and 74.3% for ultrasound and 100%, 86.7% and 92.2% for computed tomography, respectively.
Conclusion: Diagnosis based on patients’ laboratory and imaging data, in combination with, the surgeon’s judgement appears to yield the best outcomes in patients with suspicion of acute appendicitis.
Keywords: Acute appendicitis, diagnosis, ultrasound, tomography, appendectomy
Ethics committee approval was received for this study from the Institutional Review Board of Ethical Committee, Istanbul 29 Mayıs Hospital.
Due to retrospective design of the study, written informed consent could not be taken from the patients. Institutional Review Board from the Ethical Committee of the Hospital has been considered.
Externally peer-reviewed.
Concept - M.H.; Design - M.H., C.E.; Supervision - M.Ş.; Funding - M.H., C.E., M.T., M.Ş.; Materials - M.H., C.E., M.T., M.Ş.; Data Collection and/or Processing - M.H.; Analysis and/or Interpretation - M.H., C.E., M.T., M.Ş.; Literature Review - M.H.; Writer - M.H., C.E.; Critical Review - M.T., M.Ş.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.