Published: 2020-03-26

Comparison of performance statistics of CT scan and ultrasonography in complicated appendicitis: experience in a tertiary care centre

Harekrishna Majhi, Pramit Ballav Panigrahi, Abinasha Mohapatra


Background: This study is conducted from November 2018 to November 2019 in this institute, where comparison of performance statistics is done between CT scan and Ultrasonography in patients with complicated appendicitis scheduled for conservative management, elective or emergency surgery.  Aim of the study was to evaluate and compare the performance statistics of CT scan and Ultrasonography in complicated appendicitis.

Methods: The CT scan or USG findings of 87 patients were reviewed. The patients were divided into two groups i.e. CT scan group (group-1/18 patients), USG group (group-2/69 patients). Satistical analysis Student”s t-test, Fischer”s test, p-value, k-value.

Results: Clinical signs, CT findings, USG findings, complications at surgery and histological examinations were noted. 2, 3, 13, patients presenting with CT features and 5, 13, 51 patients presenting with USG features of appendicular perforation, peri-appendicular abscess, inflammatory appendicular mass respectively. No clinical signs showed a significant association with the presence of appendicular perforation, peri-appendicular abscess, inflammatory appendicular mass or the complication encountered at surgery.

Conclusions: In this study, by comparing CT scan group and USG group in complicated acute appendicitis, CT scan can change the plan of management in doubtful cases, decrease length of hospital stay and expenses, reduce the complication rate and negative laparotomy rate, and reduce the episodes of conversion to open surgery.


Computerized tomography, Complicated appendicitis, Inflammatory appendicular mass, Performance statistics, Ultrasonography

Full Text:



Addiss DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol. 1990 Nov 1;132(5):910-25.

Liu CD, McFadden DW. Acute abdomen and appendix. Surg: Sci Princip Prac. 1997;2:1246-61.

Nitecki S, Assalia A, Schein M. Contemporary management of the appendiceal mass. Bri J Surg. 1993 Jan;80(1):18-20.

Terasawa T, Blackmore CC, Bent S, Kohlwes RJ. Systematic review: computed tomography and ultrasonography to detect acute appendicitis in adults and adolescents. Annal Inter Med. 2004 Oct 5;141(7):537-46.

Bhandari RS, Thakur DK, Singh KP. Revisiting appendicular lump. J Nepal Med Assoc. 2010 Apr 1;49(178):108-111.

Willemsen PJ, Hoorntje LE, Eddes EH, Ploeg RJ. The need for interval appendectomy after resolution of an appendiceal mass questioned. Diges Surg. 2002;19(3):216-22.

Balthazar EJ, Megibow AJ, Hulnick D, Gordon RB, Naidich DP, Beranbaum ER. CT of appendicitis. Am J Roentgenol. 1986 Oct 1;147(4):705-10.

Tsukada K, T Miyazaki, H Katoh, N Masuda, H Oiima, M Fukuchi, et al. CT in diagnosis of complicated acute appendicitis. Dig Liver Dis. 2003;36:195-8.

Horrow MM, White DS, Horrow JC. Differentiation of perforated from nonperforated appendicitis at CT. Radiology. 2003 Apr;227(1):46-51.

Anderson RE, Petzold MG. Non-surgical treatment of appendiceal abscess or phlegmon : a systematic review and metaanalysis. Ann Surg. 2007;246:741-8.

Bailey H. The Ochsner-Sherren (delayed) treatment of acute appendicitis: indications and technique. Bri Med J. 1930 Jan 25;1(3603):140.

Kaya B, Sana B, Eris C, Kutanis R. Immediate appendectomy for appendiceal mass. Ulus Travma Acil Cerrahi Derg. 2012 Jan 1;18(1):71-4.