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Sedaqat M. Assessment of the Diagnostic Value of Preoperative Ultrasound in Predicting the Difficulty of Appendectomy. KJMS 2025; 10 (19) :58-66
URL: http://kjms.knu.edu.af/article-1-64-en.html

Introduction: Appendicitis is one of the most common surgical emergencies of the abdomen, where rapid diagnosis and timely surgical intervention are essential to prevent complications such as perforation. Despite advances in imaging techniques, predicting the difficulty of appendectomy remains a clinical challenge. Ultrasonography, as a non-invasive and widely accessible modality, may play a significant role in this context. This study aimed to evaluate the role of ultrasonography in predicting the difficulty of appendectomy and its impact on surgical planning.
Materials and Methods: A systematic review was conducted on articles published between 2000 and 2024 in the PubMed and Scopus databases. Studies addressing the use of ultrasonography in the diagnosis of appendicitis and its correlation with preoperative findings, intraoperative outcomes, or histopathological results were included. Out of 156 initially identified studies, 15 relevant articles were selected for final analysis.
Results: Ultrasonography can identify features of complicated appendicitis such as an appendix diameter greater than 6 mm, appendicolith, peritonitis, abscess, and non-compressible inflamed fat. These findings are significantly associated with surgical difficulty and can guide surgeons in selecting the most appropriate operative approach. Furthermore, ultrasonography has demonstrated high specificity in detecting true-positive acute appendicitis, reduced false-positive diagnoses, and consequently lowered the rate of unnecessary appendectomies.
Conclusion: In addition to its diagnostic role, ultrasonography is an effective tool for predicting the difficulty of appendectomy. Recognition of specific sonographic features can improve surgical planning and enhance clinical outcomes. With ongoing advances in imaging technology and the standardization of diagnostic protocols, the role of ultrasonography in the management of complicated appendicitis is expected to become even more prominent.