Background: Acute appendicitis ranks among the most frequent causes of acute abdominal emergencies, making accurate diagnosis and timely surgery essential. Ultrasonography (US) and computed tomography (CT) are pivotal in achieving accurate diagnoses for this condition. This study aimed to evaluate the accuracy of CT in identifying appendicitis in ultrasound-negative cases and to assess the efficacy of CT in identifying complications of appendicitis. Methods: The study included patients aged 15 – 50 years, who were admitted to the surgical emergency ward with clinical symptoms suggestive of acute inflammation, such as right iliac fossa pain, fever, and vomiting. A total of fifty patients were selected as the study sample. Detailed clinical history was recorded using the prescribed proforma. Informed consent was obtained from all participating patients, and the study protocol was approved by the institutional ethical committee. Among the participants, 32 patients with either negative ultrasound findings or equivocal results underwent CT examination to obtain further diagnostic information. Results: The examination of the position of the appendix on CT scan showed 78% of cases having retrocaecal appendix followed by the pelvic position in 14%, pre, and post-ileal in 6% of cases, and the rest in 2% of cases. The existence of free fluid was in 18% of cases, mesenteric lymphadenitis in 26% of cases, and normal appearance in 56% of cases. In this study, 38% of the study group has appendicitis, diagnosed by Computed Tomography. The age group 20-24 years has a higher incidence of acute appendicitis. Shows 6% of patients among the study population with free fluid in the Right iliac fossa show appendicular perforation/abscess. Conclusion: CT plays a more precise role in diagnosing appendicitis, especially in cases where ultrasound results are negative. Although the role of ultrasound cannot be underrated as being non-invasive, having a quick acquisition time, being relatively cost-effective, and most importantly, not requiring the use of ionized contrast agents or oral preparation, thus eliminating radiation exposure. The CT scan can as a second-line investigation with higher significant sensitivity, specificity, positive predictive value, and negative predictive value.

Background: Acute appendicitis ranks among the most frequent causes of acute abdominal emergencies, making accurate diagnosis and timely surgery essential. Ultrasonography (US) and computed tomography (CT) are pivotal in achieving accurate diagnoses for this condition. This study aimed to evaluate the accuracy of CT in identifying appendicitis in ultrasound-negative cases and to assess the efficacy of CT in identifying complications of appendicitis. Methods: The study included patients aged 15 – 50 years, who were admitted to the surgical emergency ward with clinical symptoms suggestive of acute inflammation, such as right iliac fossa pain, fever, and vomiting. A total of fifty patients were selected as the study sample. Detailed clinical history was recorded using the prescribed proforma. Informed consent was obtained from all participating patients, and the study protocol was approved by the institutional ethical committee. Among the participants, 32 patients with either negative ultrasound findings or equivocal results underwent CT examination to obtain further diagnostic information. Results: The examination of the position of the appendix on CT scan showed 78% of cases having retrocaecal appendix followed by the pelvic position in 14%, pre, and post-ileal in 6% of cases, and the rest in 2% of cases. The existence of free fluid was in 18% of cases, mesenteric lymphadenitis in 26% of cases, and normal appearance in 56% of cases. In this study, 38% of the study group has appendicitis, diagnosed by Computed Tomography. The age group 20-24 years has a higher incidence of acute appendicitis. Shows 6% of patients among the study population with free fluid in the Right iliac fossa show appendicular perforation/abscess. Conclusion: CT plays a more precise role in diagnosing appendicitis, especially in cases where ultrasound results are negative. Although the role of ultrasound cannot be underrated as being non-invasive, having a quick acquisition time, being relatively cost-effective, and most importantly, not requiring the use of ionized contrast agents or oral preparation, thus eliminating radiation exposure. The CT scan can as a second-line investigation with higher significant sensitivity, specificity, positive predictive value, and negative predictive value.