Effectiveness of ultrasound in appendicitis diagnosis by emergency department doctors; systematic review

Abstract

Patients with appendicitis are increasingly assessed using computed tomography, but its routine use is under scrutiny due to concerns about long-term malignancy risk from ionizing radiation. Emergency departments employ point-of-care ultrasound as a rapid, noninvasive, and cost-effective tool for diagnosing trauma, severe abdominal pain, chest pain, and dyspnea. In this systematic review, we aim to assess the effectiveness of ultrasound for diagnosing acute appendicitis in the emergency room. We conducted a comprehensive review, obtaining biomedical literature from databases such as PubMed, Ovid MEDLINE, and Google Scholar. Our inclusion criteria focused on studies related to emergency department appendicitis diagnosis. The database search yielded 391 items, and after deduplication and filtering, 10 studies meeting inclusion criteria were included for analysis. Ultrasound sensitivity ranged from 0.44 to 0.99, while specificity varied from 0.63 to 0.96. The overall mean sensitivity and specificity were 0.80 and 0.81, respectively.