Perforated versus Nonperforated Acute Appendicitis: Accuracy of Multidetector CT Detection

Bixby, Sarah D.; Lucey, Brian C.; Soto, Jorge A.; Theysohn, Jens; Ozonoff, Al; Varghese, Jose C.

doi:10.1148/radiol.2413051896

Cited by 128 publications

(71 citation statements)

References 21 publications

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“…Others have suggested that overall CT sensitivity for this task may be poor since unless abscess or extraluminal gas is present, CT cannot enable the diagnosis of perforation (25). On the other hand, taking into account acute appendicitis as a whole, with concern to all of its pathological stages, accurate diagnosis seems to be affected by the exploitation of imaging modalities.…”

Section: Age Did Not Significantly Differ Between Groups (Anova P-vamentioning

confidence: 99%

Efficacy of preoperative computed tomography imaging to reduce negative appendectomies in patients undergoing surgery for left lower quadrant abdominal pain

Kontopodis¹

2014

gchir

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Appendicitis is one of the most common causes of acute abdominal pain for which patients seek medical assistance in surgical emergency departments. Approximately 250,000 cases of appendicitis occur annually in the United States accounting for an estimated 1 million hospital days per year. A life table model suggests that the lifetime risk of appendicitis is 8.6% for males and 6.7% for females while the lifetime risk of appendectomy is 12.0% and 23.1% respectively (1, 2).Early diagnosis and surgical intervention are essential for the successful management of this condition. This is not always straightforward since clinical evaluation such as history, physical examination and laboratory tests can be misleading in the same that the differential diagnosis includes conditions with similar presentation which require medical treatment. It has been reported that the accuracy of clinical diagnosis for acute appendicitis ranges from 71% to 97% and scoring tests have been developed to assist the clinician in the evaluation of such a condition, the most widely accepted being Alvarado's score (2-4). This includes clinical presentation, physical findings and laboratory examinations (5). To avoid morbidity and mortality associated with appendiceal rupture, it would have been acceptable decades ago to remove healthy appendixes at a rate of 20% based on physical examination (6). In the same time the consequences of a negative appendectomy include intra-abdominal adhesions, negative effects of anesthesia, increase of cost etc. while complications after a negative appendectomy occur in 6% and reoperation is needed in 2% of patients (7).

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Section: Age Did Not Significantly Differ Between Groups (Anova P-vamentioning

confidence: 99%

Efficacy of preoperative computed tomography imaging to reduce negative appendectomies in patients undergoing surgery for left lower quadrant abdominal pain

Kontopodis¹

2014

gchir

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“…[6] Computed tomography is a highly reliable non-invasive diagnostic tool to assess for acute appendicitis. Abdominal CT is a well-established technique in the study of acute abdominal pain and has shown high sensitivity and specificity for diagnosing and differentiating appendicitis, providing an accurate diagnosis in the early stages of the disease [7], [8]. Barium studies may be used to demonstrate abnormally located caecum and ascending colon.…”

Section: Discussion:-mentioning

confidence: 99%

A Rare Case of Perforated Left Upper Quadrant Appendicitis.

Alabduljabbar¹,

ijar²

2018

IJAR

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“…3,8,[10][11][12][13]15,16 For example, Hansen et al described radiologic factors that strongly correlate with the histologic diagnosis of AA, as follows: (i) the appendix diameter, (ii) periappendiceal fat staining, (iii) appendicoliths, (iv) extraluminal air, (v) dependent fluid.…”

Section: Discussionmentioning

confidence: 99%

Contrast‐enhanced multidetector‐row computed tomography can predict pathological findings of acute appendicitis in children

Hashizume

Iinuma

Hirayama

et al. 2015

Acute Medicine & Surgery

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Aims:To retrospectively evaluate the correlation between multidetector-row computed tomography findings of acute appendicitis and the pathological status of acute appendicitis, and evaluate the capability of multidetector-row computed tomography to predict the pathological status of acute appendicitis in children. Methods:The presence of a distended appendix (>6 mm in transverse diameter) was used as a primary sign to indicate the presence of appendiceal inflammation. The presence of appendiceal wall thickening (>1 mm) and enhanced appendiceal wall continuity were also used as predictive findings to reflect the degree of progression of acute appendicitis on multidetector-row computed tomography findings. The findings of each individual case were classified into four grades. The final pathological diagnosis was classified into four groups: normal findings, only mucosal inflammation, inflammation with intramural spreading, and gangrenous. The relationship between the pathological grades and computed tomography grades was analyzed using Spearman's rank correlation test.Results: Four of six cases in Grade 0 reflected normal appendiceal findings (66.7%) and 3 of 5 cases in Grade I reflected only mucosal inflammation status (60.0%). Forty-four of 51 cases in Grade II reflected intramural inflammation status (86.3%), and 40 of 57 cases in Grade III reflected gangrenous status (70.2%). The multidetector-row computed tomography grade was significantly correlated to the pathological grade with Spearman's rank correlation coefficient of 0.689 (P < 0.001).Conclusions: There was a close relationship between the multidetector-row computed tomography imaging findings and the pathological findings. This preoperative information is extremely useful for decision-making in the treatment strategy for acute appendicitis in children.

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Perforated versus Nonperforated Acute Appendicitis: Accuracy of Multidetector CT Detection

Abstract: Although certain multidetector CT findings are very specific for the diagnosis of perforated appendicitis, overall multidetector CT sensitivity is poor. Unless abscess or extraluminal gas is present, multidetector CT cannot enable the diagnosis of perforation.

Cited by 128 publications

References 21 publications

Efficacy of preoperative computed tomography imaging to reduce negative appendectomies in patients undergoing surgery for left lower quadrant abdominal pain

Efficacy of preoperative computed tomography imaging to reduce negative appendectomies in patients undergoing surgery for left lower quadrant abdominal pain

A Rare Case of Perforated Left Upper Quadrant Appendicitis.

Contrast‐enhanced multidetector‐row computed tomography can predict pathological findings of acute appendicitis in children

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