Validity of diagnostic laparoscopy in diagnosis of acute appendicitis

Abstract

Background: Acute appendicitis is the most common surgical emergency encountered in general population, especially among the pediatric age group. Till date, there are no definitive diagnostic tools available for deriving precise diagnosis. This study was carried out to evaluate the validity of diagnostic laparoscopy in detecting acute appendicitis. Methods: This cross sectional study was carried out among 130 patients who were clinically diagnosed with acute appendicitis. Diagnostic laparoscopy was carried out to evaluate the appendix and was documented. In necessary situations, the procedure was converted into appendectomy. The excised specimen was sent for histopathological examination.Results: On comparing the validity of clinical features with respect to diagnostic laparoscopy, highest sensitivity was observed with RIF tenderness (100%) followed by anorexia (78.8%) and nausea/ vomiting (74.7%). However, specificity was found to be highest for migratory pain (83.9%). The sensitivity of the diagnostic laparoscopy when compared to the gold standard histopathological finding was 97.1%.Conclusion: Since diagnostic laparoscopy is a non invasive tool, it may be used as a standard protocol for immediate management of acute appendicitis, and also be used as a potent tool for differential diagnosis among women of the reproductive age.