Evaluation of Noncontract computed tomography in diagnosing acute appendicitis

Introduction: Appendicitis is a common disease, having a lifetime incidence of 7%. Surgeons have traditionally accepted negative appendectomy rate up to 20%. It is because of clinical myriad. Objectives of study were to determine the role of Noncontract Computed Tomography (NCCT) imaging in the detection of suspicious case of appendicitis. To estimate negative appendectomy rate (NAR) in preoperative evaluation of computed tomography (CT). Evaluate significance of Clinical, radiological and intraoperative parameters for diagnosing appendicitis. Material and Method: This is evaluation of diagnostic test of 450 patients coming to Emergency Department with suspicion of acute Appendicitis have undergone NCCT. The study will be carried out in the Department of surgery Dr Shankarrao Chavan Government Medical College Nanded over a period of 24 months. Result: An appendectomy was performed in 367 patients. All 367 patients underwent surgery their clinical and radiological correlation and intra-operative finding noted and surgical specimen sent for histopathological correlation. Clinically right iliac fossa pain, vomitting, temperature, RIF Tenderness, were found to be more consistent with acute appendicitis with significant p values. On establishing role of NCCT abdominal scan in diagnosing acute appendicitis significant parameters are Enlarged Appendix, Periappendicial fat stranding, Focal cecal apical thickening, Intra luminal Air these parameter are significant with p values. Omentum in right iliac fossa, Inflammed appendix, Periappendicular free fluid/pus is more consistent intra-operatively during appendectomy with significant p values 0.028.0.045, 0.026 respectively. Negative appendectomy rate in our study is 3.81%. Conclusion: There was a significant reduction in the Negative Appendectomy Rate in patients undergoing NCCT for diagnosis. Uses of specific clinical radiological and intra-operative parameters become significant in diagnosing appendicitis. NAR might have medico legal importance to debate for difficult in diagnosing appendicitis preoperatively.