Effect of surgeon's judgement on the diagnosis of acute appendicitis


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Hasbahçeci M., EROL C., Törö M., Şeker M.

Turkish Journal of Surgery, vol.30, no.1, pp.22-27, 2014 (Scopus) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 30 Issue: 1
  • Publication Date: 2014
  • Doi Number: 10.5152/ucd.2014.2582
  • Journal Name: Turkish Journal of Surgery
  • Journal Indexes: Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.22-27
  • Keywords: Acute appendicitis, diagnosis, ultrasound, tomography, appendectomy
  • Istanbul Medipol University Affiliated: Yes

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. © Copyright 2014.