Accuracy of Per-rectal Examination for Diagnosis and Predicting Type of Appendix in Patients with Acute Appendicitis
Keywords:Acute appendicitis, Per-rectal examination, Appendix type
Introduction: Type of appendix is a well-recognized factor responsible for difficulty in appendectomy. Traditionally per-rectal examination should be performed in all patients with acute abdomen. Our goal of this study was to demonstrate the accuracy of per-rectal examination for diagnosis of acute appendicitis and to predict type of appendix by the result of per-rectal examination.
Material and Methods: We reviewed the relationship between positive per-rectal examination and all types of appendix in patients with acute appendicitis from January 2006 to October 2006 at our institution.
Results: There were 142 patients in the study including 68 males. The mean age at diagnosis was 32.8 years in male and 40.7 years in female. Per-rectal examination was performed in 113/142 (80%) patients. At operation, pelvic type was the most common type. Accuracy of per-rectal examination for diagnosis of acute appendicitis and predicting pelvic-type appendicitis are 52.3% and 48% respectively.
Conclusion: Our study demonstrated that the accuracy of per-rectal examination as one of clinical diagnostic tools had low sensitivity and specificity and could not be used routinely as a predictor of type and diagnosis of acute appendicitis.
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