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Keywords:
Abdomen, Emergency, Ultrasound, Diagnostic procedure, Surgery
Authors:
F. Scutt, M. E. R. Marsden, N. D'Souza, S. Bottomley, N. Nagarajah, A. Higginson, S. Toh; Portsmouth/UK
DOI:
10.1594/ecr2016/C-2373
Aims and objectives
Appendicectomy is the most commonly performed emergency surgery procedure in the UK [1]. Diagnosis of acute appendicitis often includes established imaging techniques such as ultrasound scan (USS),
CT and MRI,
which are adjuncts that can improve diagnostic accuracy and reduce negative appendicectomy rate (NAR) when correlated with history and examination findings.
NAR in the UK is higher than expected in a developed healthcare system at 20.6% [2]; an estimated 8000 of the 40,000 appendicectomies carried out annually in the UK are negative [1].
A negative appendicectomy will incur costs to the local hospital: these are principally the costs of length of stay and theatre time.
Other costs can be more difficult to measure: treatment of complications will incur their own costs to the hospital and primary care.
Recovery time from surgery away from work reduces economic productivity— not only for the patient,
but their primary caregiver as well.
This study aimed to identify the impact of USS on negative appendicectomy rates,
with a more specific focus on the effect of operator skill in relation to this.