Ultrasound in the differential diagnosis of acute appendicitis

Acute appendicitis is one of the most common causes of abdominal emergency surgery. Experienced investigators will have an accuracy of more than 90% to diagnose the acute appendicitis. Sonography may diagnose many diseases which have similar clinical symptoms to the acute appendicitis.
In a prospective descriptive study, we reviewed the sonographic findings of 230 patients who were suspected to have acute appendicitis. The patients with typical clinical and laboratory sign were excluded from the study. The diagnostic accuracy of sonography was evaluated in detection of diseases with similar clinical symptoms among the patients.
In the present study, seventy-two (31%) cases had abdominal or pelvic pain of unknown origin and they were ultimately dismissed without any specific diagnosis. Acute appendicitis was approved in 78 out of 158 patients after the surgery and appendectomy and sonographic results in 70 cases (89.7%) was positive integer. In sixty out of 80 (82.5%) patients without risk of acute appendicitis, ultrasound accurately diagnosed that the acute gynecological diseases were the most common pathological cause of diseases. The urinary tract diseases and gastrointestinal diseases were other cases.
Sonography is a valuable modality to establish the differential diagnosis of acute appendicitis, which is recommended for evaluation of patients with equivocal clinical diagnosis. Therefore, in patients with a clinical diagnosis of acute appendicitis and negative ultrasonographic results, assessment of other abdominal organs and pelvic cavity by ultrasound can be a valuable diagnostic complementary procedure.