Digital rectal examination not appropriate for acute appendicitis

Yashwant R. Lamture., Varsha P.Gajbhiye and Shinde R.K

Introduction: A prompt and accurate diagnosis of appendicitis is crucial. Careful history taking and physical examination have an important role in the correct diagnosis. The physical examination for diagnosis of appendicitis, digital rectal examination (DRE) has been considered a very important. This traditional teaching that DRE should be performed routinely in all patients with abdominal pain has been supported in most surgical textbooks. On the other hand, several articles found that DRE only occasionaly gives useful information for evaluation of acute appendicitis and it often causes discomfort to the patient. To date, some review articles investigated the role of DRE for diagnosis of acute appendicitis. Digital rectal examination (DRE) has been traditionally recommended to evaluate acute appendicitis, although these reports indicate its lack of utility for this diagnosis. Hence, the aim of the current study was to determine role of DRE by finding its accuracy.
Material and method: In the prospective longitudinal and observational study involving the patients between any age group coming to the hospital with Right Iliac Fossa pain. The data was analysed using the SPSS 17.0 statistical software. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of DRE calculated. Ethical approval for the study was obtained from the Ethics Committee Review Board of DMIMS University
Observation: Around 418 subjects were included in the study, consists of 251(60.05) of males and 167(39.95) from female gender.
Discussion and Conclusion: Acute appendicitis cannot be ruled in or out through the results of digital rectal examination. Reconsideration is warranted for the traditional teaching that digital rectal examination should be performed routinely in all patients with suspected appendicitis. Situations in which the digital rectal examination has an important role should be further investigated.

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