Abstract

Acute appendicitis (AA) is a common diagnosis that requires surgical treatment. Bedside ultrasound (BUS) is a very useful tool in emergency medicine (EM). We aimed to evaluate the skills of emergency medicine specialists performing bedside ultrasound (EMUS) in patients with suspected AA. In this prospective, cross-sectional study, 200 patients presenting to the emergency department (ED) with acute abdominal pain between January 1 and December 31, 2015, were evaluated. First, an EM specialist performed BUS, followed by a formal ultrasound (US) and surgical consultation when indicated. Initial diagnoses, hospital admission or ED discharge, and final diagnoses were documented via biopsy or telephone follow-up. Comparisons were made using ROC curve analysis. A total of 192 patients were included in the study (mean age: 32.4±12.8 years; 52.1% female, 47.9% male). AA was reported in 47.0% of patients who underwent computed tomography (CT) (p=0.001). The values measured for US (RUS) and EMUS performed by radiology in the diagnosis of AA were: sensitivity (63.64% and 77.53%) and specificity (92.31% and 72.38%), respectively. AUC values were 0.78 and 0.75. RUS was found to be statistically significantly better in diagnosing AA (p=0.032). Although EMUS had higher sensitivity in ruling out AA, there was no statistically significant difference compared to RUS (p=0.156). EMUS is a useful tool in the diagnosis of AA. It can be used by emergency medicine specialists to diagnose AA earlier, prevent delays in surgery, and reduce radiation exposure by eliminating the need for CT imaging.

Key words: Acute appendicitis, bedside ultrasound, emergency radiology