Background: Acute appendicitis is one of the most common causes of acute abdominal pain requiring urgent surgical intervention. Early and accurate diagnosis is essential to prevent complications such as perforation and peritonitis. Ultrasonography is frequently used as a first‑line imaging modality due to its safety, availability, and absence of ionizing radiation. Objective: To evaluate the diagnostic accuracy of ultrasonography in detecting acute appendicitis by comparing ultrasound findings with the final diagnosis based on surgical and histopathological results. Methods: This prospective diagnostic accuracy study included 250 patients with clinical suspicion of acute appendicitis who underwent trans‑abdominal ultrasound examination at Al‑Salam Teaching Hospital in Mosul, Iraq, between August 2021 and September 2024. Ultrasound findings were compared with the reference standard consisting of intraoperative findings and histopathological examination. Sensitivity, specificity, positive predictive value, negative predictive value, and overall diagnostic accuracy were calculated. Results: Among the 250 patients included in the study, 190 (76%) were confirmed to have acute appendicitis. Ultrasound findings were positive in 170 (68%) patients. The diagnostic performance of ultrasound demonstrated a sensitivity of 86.8%, specificity of 91.7%, positive predictive value of 97.1%, negative predictive value of 68.8%, and an overall diagnostic accuracy of 88%. Conclusion: Ultrasonography demonstrates high sensitivity and specificity in diagnosing acute appendicitis and can be considered a reliable first‑line imaging modality in patients with suspected appendicitis. Its availability, safety, and cost‑effectiveness make it particularly valuable in resource‑limited healthcare settings.
1*Haneen Ahmed Najeeb, 2Modhar Thamer Mukhlef AL-Taan, 3Waleed Khalid Ali (Wed,) studied this question.