Diagnosis of acute right lower quadrant pain and appendicitis by CT scan: Do we still need the clinician?

P. Hookman, Jamie S Barkin

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

This retrospective study was performed to evaluate the impact of appendiceal computed tomography (CT) on negative appendectomy and appendiceal perforation rates. The population consisted of 493 consecutive patients who underwent appendectomy between 1992 and 1995. They were compared with 209 consecutive patients who underwent appendectomy in 1997 (59% of whom had appendiceal CT) and 206 patients who underwent appendiceal CT in 1997 without subsequent appendectomy. The authors found that before the availability of appendiceal CT, 98 of 493 patients (20%) who underwent surgery for suspected appendicitis had a normal appendix. Whereas, after CT availability, only 15 of 209 patients (7%) who were taken to surgery for appendectomy had a normal appendix. In addition to this decrease in negative appendectomy rates, the appendiceal perforation rates also dropped significantly from 22% before CT availability to 14% after CT availability. Of 206 patients who underwent appendiceal CT in 1997, 105 (51%) had a normal appendix, and thus avoided appendectomy. CT identified alternate diagnosis in these patients. Subgroup analysis revealed that the greatest change in negative appendectomy rates was in women in whom the rate decreased from 35% before CT availability to 11% after CT availability. In men, negative appendectomy rates decreased from 11% to 5%. In boys, it changed from 10% to 5%. And in girls, from 18% to 12%. The authors advocate that, as a result of this study, appendiceal CT should be performed in nearly all female and many male patients. (C) 2000 by Am. Coll. of Gastroenterology.

Original languageEnglish
Pages (from-to)1355-1357
Number of pages3
JournalAmerican Journal of Gastroenterology
Volume95
Issue number5
StatePublished - May 25 2000

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ASJC Scopus subject areas

  • Gastroenterology

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