Appendicitis is one of the most common emergency presentations in Australia[1]. Diagnostic ultrasound is the imaging modality of choice in young patients with suspected appendicitis due to its accessibility and lack of ionising radiation[2]. The limitation of ultrasound is the variability of its diagnostic performance, with a wide range of sensitivity and specificity of ultrasound for appendicitis reported in the literature[3]. The variability of diagnosis can be due to a number of factors including operator expertise and body habitus of the patient. The rate of...

Retrospective audit of 261 patients presenting to a metropolitan emergency department in Melbourne with a clinical suspicion of appendicitis between July 2018 to June 2019. Patients were evaluated by sonographers of varying level of experience. Ultrasound reports, histopathology, discharge summaries and operation reports were reviewed. The ultrasound was deemed positive when the appendix was identified and there were sonographic features of appendicitis. The ultrasound was deemed negative if the appendix was not identified or there were no direct or indirect sonographic features of appendicitis. [Fig...

261 patients underwent ultrasound for suspected appendicitis and were included in our audit. The median age for our cohort was 24 years (interquartile range, 18 to 32) with 83.9% female and 16.1% male patients. Of 261 patients, the appendix was identified in 47 patients of which 40 were classified as positive for appendicitis. 221 patients were classified as negative. 56 patients underwent appendicectomy, 43 of which had histopathology confirming appendicitis. The prevalence of appendicitis in our cohort was 16%. Approximately 65% (28/43) of true positive...

The sensitivity of ultrasound for appendicitis was lower than in the reported literature, but the reported specificity was higher. A negative ultrasound for appendicitis carries a high negative predictive value which could be useful as part of the clinical algorithm when deciding whether to perform appendicectomy for patients with clinically suspected appendicitis.

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