Factors Influencing the Result of Sonographic Diagnosis of Acute Appendicitis in a Large Hospital in the Netherlands

Pepijn Eijsvogel, Sander Van Kuijk, James van Bastelaar*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objective: Appendicitis is a common surgical emergency, for which sonography is widely used to assess the presence of absence of appendicitis. The objective of this study was to identify factors associated with the diagnostic accuracy of sonography in patients with a suspected case of acute appendicitis. Methods: A retrospective review was conducted in all patients who were assessed for acute appendicitis (with sonography) in two emergency rooms of a large hospital. The sonography result was compared with the pathological report in patients who underwent surgery under suspicion of an acute appendicitis. Results: A multivariate analysis revealed that operator (radiologist or resident), time of the sonogram, site (hospital), and body mass index were independent variables significantly influencing the sonographic result. Correctly diagnosing suspected appendicitis with sonography is 2.2 times more likely when performed by a radiologist compared to a resident. Conclusions: Sonography is widely used in diagnosing appendicitis in the emergency room. In this study, the probability of sonography being correctly diagnosed decreases during on-call hours or when conducted by a resident in patients with suspected appendicitis. Furthermore, increasing body mass index decreases the probability of a sonogram being correct when conducted by a resident compared to a radiologist.

Original languageEnglish
Article number8756479319887138
Pages (from-to)103-109
Number of pages7
JournalJournal of Diagnostic Medical Sonography
Issue number2
Early online date8 Nov 2019
Publication statusPublished - Mar 2020


  • sonography
  • acute appendicitis
  • diagnosis
  • and diagnostic imaging
  • CT
  • US


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