ACCURACY IN DIAGNOSIS ACUTE APPENDICITIS IN BUDDHACHINNARAJ HOSPITAL

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ACCURACY IN DIAGNOSIS ACUTE
APPENDICITIS
IN BUDDHACHINNARAJ HOSPITAL
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????????????????
Acute appendicitis ???????????????????
?????????????????????????? Acute
abdomen???????????????????????????????????????????
??????????????????????????????
??????????????????????????????????????????????????
??????????????????????????????????????????
?????? ??????????????????????????????????????????
????????????????????
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?????????????
Bochner H ,Et al .anamnesbischer Angaben and
Klinischer Befunde fuer dic Diagnosis der
akuten ????????????? Cohort study ??????????
Acute abdomen 1254 ??? ?????????????????????????
???????????????????????????????? Acute
appendicitis ?????????????????????????????????????
???????? 95 ?????? rebound tenderness,tendernes
s in the RLQ,pain RLQ at presentation, onset
of pain RLQ,rigidity,guarding Bowden T,et al.
?????????????????????????????????????????????
Acute appendicitis ?????????????????
CT????????? CT ??????????????? CT ?????????????
80 ????????????? CT???????????????????? 95
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????????????

• ?????????????????????????????????? Acute
  Appendicitis ?????????????????????
• ??????????????????????????????????????????????????
  ???????????????????????? admit ???? Acute abdomen
• ??????????????????????????????????????????????????
  ????????????????? Acute Appendicitis

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?????????

• ???????? Retrospective descriptive ???Case
  control study
• ?? H.N. ?????????????? Definitive diagnosis
  ???????????? admit ????????? acute abdomen
  ?????????????1?????? - 15 ????????
  ????????????????????????????????????
• ??????????????????????????????????????????????????
  ???

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• ???????????????????? ???????????? admit ????
  Acute abdomen ?????????????????? H.N.???????????
• ?????????????????? ?????????? refer
  ??????????????????? Definitive diagnosis ,
  ??????????????????????????????? , ????????????
  interval appendectomies , ?????????? discharge
  ?????????? 15 ???????? ?.?. 2543 , ???????? ,
  ??????????

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??????????

• Acute abdomen ??? ?????????????????? 24 ??.
  ?????? admit
• Definitive diagnosis
• Final diagnosis
• Leukocytosis with neutrophil predominant ???
  WBCgt11,000 cell/cu.mm ??? N gt 75

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??????????

• Mild inflammation ??? Normal appendix
• Rovsings sign positive
• Psoas sign positive
• Obtulator sign positive

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??????????
Subject

• ?????????????????????????????????? ???
  420 ???
• ???????????????? Acute abdomen 310 ???
  ?????????
  ??????? refer
  32
  ???
  
  
  ???????????????????????
  9 ???
  ????????? interval
  appendectomies 3
  ??? ????????
  
  19 ???
  ??????????
  2 ???
  ????????? 213
  ??? ??????? 50.71
  
  
• ?????????????
  207 ???
  

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??????? Acute appendicitis ??????? 45.41
?????????? Acute abdomen?????????????????????????
???? 20 - 29 ??

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Accuracy in diagnosis of acute appendicitis
Accuracy 90(85 - 94) sensitivity 83(75 - 89)
specificity 97(78-100) PPV 99(93 - 100)
NPV57(47 - 71)
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????????????????????????????????????? Appendix
Accuracy 86 (78 - 91)
Accuracy 86 (78 - 91)
Sensitivity 83(74 - 89)
Specificity 96(78 - 100)
Specificity 96(78 - 100)
PPV 99(93 - 100)
NPV 57 (37 - 77)
NPV 57 (37 - 77)
Negative appendectomies 17 (11 - 25)
Ruptured appendicitis 19
(12 - 27)
(95 CI)
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??????????????????????????????????????????????????
Acute appendicitis
??? p- value lt 0.05
14
??????????????????????????????????????????????????
Acute appendicitis
??? p- value lt 0.05
15
??????????????????????????????????????????????????
Acute appendicitis
??? p- value lt 0.05
16
????????????????????????????????????? Acute
appendicitis
17
???????
1. ??????????????????? 50 ??????????????????????
?????????? - Acute appendicitis ??????? 28
- Acute abdomen ????????????????????????????
? 41 2. ????????????????????????????????????????
??????????????????????? ????????????????? 95
CI ????? 3. ???????????????????????????? Acute
appendicitis ????????????????????????
????????? ?????????????? Acute appendicitis
????????????????????????????
4.????????????????????????????????????????????
18
???????
5. ??????????? sign positive ????????????????????
??????? 6. ??????????????????????????????????
90.41 ????? rupture appendix ??? 18.75
?????????????????????????????????????????
THE END