TH5.9 Role of Ultrasound in Management of Acute Appendicitis

Abstract

Abstract Aim Assess the outcomes of suspected appendicitis patients who had an abdo-pelvic ultrasound, and whether the scan made a difference to their management. Method Cycle 1: we collected data retrospectively for confirmed appendicitis patients admitted for the period betweeen 03/06/2021–01/09/2021. Clinical coding department supplied a database of EAU admissions diagnised with appendicitis based on histology. Cycle 2: we collected data retrospectively for all surgical patients with acute abdominal pain during the period between 1/11/2021–30/11/2021. Ultrasounds requested were provided by the Radiology department. Admission summaries were used to assess patients' management. Intervention Presentation of Audit results in departmental teaching, Teaching to junior doctors on the NICE guidelines for management of Appendicitis. Results Cycle 1: Out of 60 patients, only 10 were included as most patients had CT scan. 25% of which suggested appendicitis and 25% suggested different pathology. The appendix couldn't be visualised in 75%. Cycle 2: Out of 83 patients, 23 patients were included as suspected appendicitis. Confirmed cases were 4.34%, not visualized were 86.96% and NAD 8.70% (their final diagnosis on discharge: Appendicitis). Other suspected pathologies of biliary, gynaecological and post-op collections were mostly correctly confirmed/denied. Conclusions Ultrasound was very informative in Biliary pathology, Gynae Pathology, Other pathology like Hematoma, post-op collection. However, in terms of suspected appendicitis, it was only informative in a rare occurrence. Of the patients who were diagnosed as Appendicitis in the final diagnosis, only an eighth were confirmed by US. Ultrasound didn't change the management plan in majority of patients with suspected appendicitis.