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Background and Objective: Acute appendicitis is the most common cause of emergency surgery. Diagnosis is based on history and physical examinations. This aim of this study was to investigate some factors which increase the likelihood of positive appendicitis. Materials and Methods: This descriptive study was conducted on 100 patients (65 males and 35 females) with clinical diagnosis of acute appendicitis in Zanjan in 2010-2011. Pathology report was our Gold Standard for diagnosis. Data was analyzed by SPSS 16. Results: On the basis of pathology reports, 85% of the patients had appendicitis. Male gender and rebound tenderness indicated an increase in the likelihood of positive appendicitis up to 3.8 and 3.08 times, respectively. Sensitivity, specificity, PPV and NPV of sonography in diagnosis were 50, 83.3, 94.7 and 21.7%, respectively. Conclusion: In this study, accuracy of acute appendicitis diagnosis according to pathology results was 85%. Two factors including “male gender” and “rebound tenderness” appeared to have high diagnostic value during positive pathology. It is suggested to consider sonography as a rapid, non-invasive and available method in the diagnosis of suspicious cases of appendicitis. However, negative sonography cannot rule out the diagnostic value of acute appendicitis.

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