A RETROSPECTIVE COMPARATIVE STUDY OF APPENDICOLITH DETECTION BY ULTRASONOGRAPHY AND HISTOPATHOLOGICAL EXAMINATION IN PATIENTS UNDERGOING APPENDECTOMY

Abstract

Background: Acute appendicitis is one of the most common surgical emergencies worldwide. The presence of an appendicolith is an important predictive factor for disease severity, and its preoperative identification may aid clinical decision-making. Abdominal ultrasonography (USG) is widely used in evaluating suspected appendicitis, but its diagnostic accuracy for detecting appendicolith remains inconsistent across studies.

Aim: To evaluate the efficacy of ultrasonography in detecting appendicolith and to correlate sonographic findings with histopathological examination (HPE) of appendectomy specimens.

Methods: This retrospective observational study included 50 patients who underwent appendectomy at Saveetha Medical College and Hospital, Chennai, India. Patients whose HPE confirmed the presence of appendicolith were analyzed. Preoperative ultrasonography reports were reviewed and compared with postoperative HPE findings. Sensitivity and specificity were calculated using paired statistical comparison.

Results: Of 50 patients (45 males, 5 females; mean age 32.5 years), HPE confirmed appendicolith in all cases. Preoperative ultrasonography identified appendicolith in 17 patients (34%), whereas 33 cases (66%) were missed. The sensitivity of USG in detecting appendicolith was 34%, comparable to prior studies. No cases of perforation or abscess were noted intraoperatively.

Conclusion: Ultrasonography, though a valuable first-line diagnostic tool in suspected acute appendicitis, has limited sensitivity (34%) for appendicolith detection. Histopathological examination remains the gold standard, and reliance on sonography alone may underestimate appendicolith prevalence. Further prospective studies integrating CT imaging may improve diagnostic accuracy.