TITLE

Appendicitis: The Impact of Computed Tomography Imaging on Negative Appendectomy and Perforation Rates

AUTHOR(S)
Balthazar, Emil J.; Rofsky, Neil M.; Zucker, Ryan
PUB. DATE
May 1998
SOURCE
American Journal of Gastroenterology;May1998, Vol. 93 Issue 5, p768
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objectives: The purposes of this study were to investigate the use of computed tomography (CT) imaging in patients with suspected acute appendicitis and to evaluate the impact of CT on negative appendectomy and perforation rates. In patients clinically diagnosed of acute appendicitis the reported overall negative appendectomy rate is about 15-20%; 10% in men and 25-45% in women of childbearing age. This is associated with a perforation rate of 21-23%. Methods: This is a retrospective analysis of 146 consecutive patients presenting with clinical symptoms suspicious of appendicitis over a 2-yr period in whom CT examinations were performed before therapy was instituted. The overall negative appendectomy and perforation rates were calculated for the entire group, as well as for the 54 women aged 15-50 yr in the childbearing cohort. Results: The negative appendectomy rate was 4% in 122 patients operated on and the perforation rate was 22%. Among 36 women 15-50 yr of age operated on, the negative appendectomy rate was 8.3% and the perforation rate was 19%. Surgery was avoided in 24 patients, 18 of whom were women of childbearing age. Conclusions: The judicious use of CT imaging in patients with equivocal clinical presentation suspected of having appendicitis led to a significant improvement in the preoperative diagnosis. It resulted in a substantial decrease in the negative appendectomy rate compared to previously published reports, without incurring an increase in the perforation rate.
ACCESSION #
16070941

 

Related Articles

  • Imaging of acute appendicitis in children: EU versus U.S. ... or US versus CT? A European perspective. Holscher, Herma C.; Heij, Hugo A. // Pediatric Radiology;May2009, Vol. 39 Issue 5, p497 

    There is substantial evidence that imaging may reduce the negative appendectomy rate, also in children. However, controversy exists about the preferred method: US or CT, and the choice appears to be determined by the side of the Atlantic Ocean. This review brings forth several arguments in...

  • Acute Appendicitis: Is Removal of a Normal Appendix Still Existing and Can We Reduce Its Rate? Khairy, Gamal // Saudi Journal of Gastroenterology;Jul2009, Vol. 15 Issue 3, p167 

    Background/Aim: To determine the incidence of negative appendectomies and to identify factors that may reduce the risk of having the normal appendices removed surgically. Design: Cross-sectional study. Setting: College of Medicine and King Khalid University Hospital, Riyadh, Saudi Arabia....

  • MDCT for suspected appendicitis in the elderly: diagnostic performance and patient outcome. Pooler, B.; Lawrence, Edward; Pickhardt, Perry // Emergency Radiology;Jan2012, Vol. 19 Issue 1, p27 

    Elderly adults are at increased risk for complications related to both delayed diagnosis of appendicitis and to unnecessary appendectomy. We assessed the diagnostic performance of computed tomography (CT) in a consecutive elderly cohort with clinically suspected appendicitis. CT findings and...

  • Abdominal pain in a pregnant woman. Muñoz, Maria; Usatine, Richard P. // Journal of Family Practice;Aug2005, Vol. 54 Issue 8, p665 

    This article examines the abdominal pain in a pregnant woman. Given the location of the pain and the lack of vaginal bleeding, the most likely diagnoses are cholecystitis and appendicitis. The ultrasound showed an enlarged and inflamed appendix. An open appendectomy was performed. In conclusion,...

  • Can Computed Tomography Scan be Performed Effectively in the Diagnosis of Acute Appendicitis without the Added Morbidity of Rectal Contrast? DEARING, DANIEL D.; RECABAREN, JAMES A.; ALEXANDER, MAGDI // American Surgeon;Oct2008, Vol. 74 Issue 10, p917 

    The highest degrees of accuracy have been demonstrated for CT scans using rectal contrast in diagnosing appendicitis. However, the administration of rectal contrast is associated with patient discomfort and rarely, rectosigmoid perforation (0.04%). Additionally, the commonly accepted negative...

  • Imaging of Appendicoliths Dropped at Laparoscopic Appendectomy and Their Complications. Buckley, Orla; Geoghegan, Tony; Ridgeway, Paul; Colhoun, Eric; Snow, Aisling; Torreggiani, William C. // Canadian Association of Radiologists Journal;Jun2007, Vol. 58 Issue 3, p146 

    The article discusses the use of laparoscopic appendectomy for patients who present with dropped appendicoliths. The advantages of this surgical technique are faster recovery, fewer wound complications, and less pain. Known complications of this procedure include recurrent or stump appendicitis,...

  • The use of a computed tomography scan to rule out appendicitis in women of childbearing age is as accurate as clinical examination: a prospective randomized trial. Lopez, Peter P.; Cohn, Stephen M.; Popkin, Charles A.; Jackowski, Julie; Michalek, Joel E.; Appendicitis Diagnostic Group // American Surgeon;Dec2007, Vol. 73 Issue 12, p1232 

    Diagnosing appendicitis continues to be a difficult task for clinicians. The use of routine CT scan has been advocated to improve the accuracy of diagnosing appendicitis. When compared with the use of clinical examination alone, CT scan was not significantly different with regard to making the...

  • Laparoscopic Appendectomy for Acute and Recurrent Appendicitis: Retrospective Analysis of a Single-Group 5-Year Experience. Fogli, Luciano; Brulatti, Mauro; Boschi, Sergio; Di Domenico, Marco; Papa, Vito; Patrizi, Patrizio; Capizzi, Francesco Domenico // Journal of Laparoendoscopic & Advanced Surgical Techniques;Apr2002, Vol. 12 Issue 2, p107 

    Background and Purpose: Twenty years after the first report of laparoscopic appendectomy (LA), its role in the treatment of appendicitis is still under debate. We report herein a retrospective analysis of our cases of LA in the last 5 years, during which we adopted a policy of an almost uniform...

  • A Retrospective Study of Two-port Appendectomy and its Comparison with Open Appendectomy and Three-port Appendectomy. Yagnik, Vipul D.; Rathod, Jignesh B.; Phatak, Ajay G. // Saudi Journal of Gastroenterology;Oct2010, Vol. 16 Issue 4, p268 

    Background/Aims: To establish the efficacy of two-port appendectomy as an alternative to standard laparoscopic and open appendectomy in the management of acute appendicitis. Materials and Methods: Of the 151 patients included in the study, 47 patients were in the open group, 61 in two-port and...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics