ACR Appropriateness Criteria® Right Lower Quadrant Pain-Suspected Appendicitis

García, Encarnación Martínez; Camacho, Marc A.; Karolyi, Daniel R.; Kim, David H.; Cash, Brooks D.; Chang, Kevin J.; Feig, Barry W.; Fowler, Kathryn J.; Kambadakone, Avinash; Lambert, Denis; Levy, Angela D.; Marin, Daniele; Moreno, Courtney C.; Peterson, Christine; Scheirey, Christopher D.; Siegel, Alan; Smith, Martin P.; Weinstein, Stefanie; Carucci, Laura R.

doi:10.1016/j.jacr.2018.09.033

Cited by 94 publications

(65 citation statements)

References 68 publications

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“…The American College of Radiology Appropriateness Criteria for pregnant women recommend graded compression grayscale US as a preferred initial method in case of suspected AA. These criteria recommend MRI as a second-line imaging method in inconclusive cases, although MRI can be used as a first-line imaging modality if available [ 72 ]. Others also recommend MRI after non-visualization or inconclusive US [ 73 ].…”

Section: Resultsmentioning

confidence: 99%

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

et al. 2020

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Background and aims: Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of nonoperative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and perioperative antibiotic therapy.

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Section: Resultsmentioning

confidence: 99%

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

et al. 2020

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“…Appropriate imaging in the diagnosis of appendicitis has resulted in a decreased negative appendectomy rate from as high as 25% to approximately 1% to 3%. [12] Some series reported that US was found to be 78% to 83% sensitive and 83% to 93% specific for the diagnosis of AA. [13,14] The use of MRI during the work-up of suspected appendicitis during pregnancy reduces the unnecessary operation rate by 50%.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic versus open appendectomy in pregnancy: A single center experience

Gök

Soydaş²,

Bayraktar³

et al. 2018

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: The aim of this study was to compare the obstetric and surgical outcomes of laparoscopic appendectomy (LA) and open appendectomy (OA) performed for pregnant women at a single center. It was the hypothesis of this study that there would be no significant difference in the results. METHODS: The medical records of 57 consecutive pregnant women who underwent an appendectomy between January 2009 and September 2018 were reviewed retrospectively. The patients were divided into 2 groups: OA and LA. The collected data included age, gestational age, diagnostic modalities used, duration of surgery, length of hospital stay, morbidity, and mortality. RESULTS: Eighteen (31%) patients underwent LA and 39 (69%) patients underwent OA. There were no significant differences in the demographic data. The duration of surgery was significantly less in the laparoscopic group (37 vs 57 minutes; p=0.005). There were no statistically significant differences in the outcomes of deep or superficial surgical site infection, length of hospital stay, pre-term delivery, or loss of the fetus. There was no mortality in either group. CONCLUSION: The results of this study suggest that LA can be a safe option for both the pregnant patient and the child. Further prospective, randomized studies with a larger group of pregnant patients with appendicitis are needed to fully determine the effects of laparoscopy in these circumstances.

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“…Thus, it is fitting to deliberate over imaging options in the context of acute appendicitis. Historically, the initial imaging modality of choice for suspected appendicitis has been CT, with alternative modalities such as magnetic resonance imaging or US reserved for children and pregnant women due to concern for radiation exposure 9. However, many emergency physicians are moving toward abdominal US as the initial imaging modality for suspected acute appendicitis, typically via the high-frequency linear probe, with sensitivity and specificity reaching values above 90% 3,10…”

Section: Discussionmentioning

confidence: 99%

Sonographic Detection of a Torsed Meckel’s Diverticulum Misinterpreted as Acute Appendicitis

Choi

Dorinzi

Pagenhardt

et al. 2019

Clinical Practice and Cases in Emergency Medicine

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A 38-year-old female presented to the emergency department (ED) with acute-onset right lower quadrant abdominal pain following two days of nausea and vomiting. Physical examination revealed right lower quadrant tenderness to palpation, rebound tenderness, and guarding. Point-of-care ultrasound (POCUS) of the right lower abdomen was performed and interpreted as probable appendicitis. However, upon laparoscopic examination of the abdomen, a benign-appearing appendix was visualized. Further investigation revealed the source of the patient’s pain to be a torsed Meckel’s diverticulum. Although rare, a torsed and inflamed Meckel’s diverticulum can be visualized by POCUS in the ED without the need for further imaging or delay.

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ACR Appropriateness Criteria® Right Lower Quadrant Pain-Suspected Appendicitis

Cited by 94 publications

References 68 publications

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

Laparoscopic versus open appendectomy in pregnancy: A single center experience

Sonographic Detection of a Torsed Meckel’s Diverticulum Misinterpreted as Acute Appendicitis

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