Accuracy of computed tomography in predicting appendiceal perforation

Journal of Pediatric Surgery
Jason D FraserShawn D St Peter

Abstract

Some surgeons use nonoperative management with or without interval appendectomy for patients who present with perforated appendicitis. These strategies depend on accurately delineating perforation by computed tomography (CT). Since 2005, our institution has used an evidence-based definition for perforation as a hole in the appendix or fecalith in the abdomen. This has been shown to clearly separate those with a high risk of abscess from those without. To quantify the ability of CT to identify which patients would meet these criteria for perforation, we tested 6 surgeons and 2 radiologists who evaluated blinded CT scans. A junior and senior surgical residents, 2 staff interventional radiologists, and 4 attending pediatric surgeons with 3 to 30 years of experience reviewed 200 CT scans of pediatric patients who had undergone a laparoscopic appendectomy. All CT scans were reviewed electronically, and the reviewers were blinded to the results, outcome, and intraoperative findings. None of the patients had a well-formed abscess on CT. The reviewers were asked to decide only on perforated or nonperforated appendicitis according to our intraoperative definition. Clinical admission data were reviewed and compared between groups. In tot...Continue Reading

References

Jun 1, 1996·Journal of Pediatric Surgery·S H Ein, B Shandling
Sep 24, 1999·JAMA : the Journal of the American Medical Association·B M Garcia PeñaG A Taylor
Sep 23, 2000·AJR. American Journal of Roentgenology·C J SivitE R Grisoni
Jan 3, 2001·AJR. American Journal of Roentgenology·L H LoweM Hernanz-Schulman
Oct 2, 2002·Radiology·Sandra E BendeckR Brooke Jeffrey
Feb 22, 2003·Journal of the American College of Surgeons·Catherine ChenSusan K Parsons
Mar 5, 2003·Radiology·Mindy M HorrowJay C Horrow
Mar 30, 2004·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·K TsukadaH Kuwano
Nov 9, 2004·Clinical Imaging·Kwok-Wan YeungChao-Peng Hsiao
Dec 22, 2004·Archives of Surgery·Adam J HansenDaniel J Johnson
Dec 23, 2006·Pediatric Radiology·Terry LevinBurton Harris
Jun 15, 2007·Journal of Pediatric Surgery·Charles J AprahamianCarroll M Harmon
Sep 13, 2007·Journal of Pediatric Surgery·Devin PuapongHarry Applebaum
May 24, 2008·The Journal of Surgical Research·Kuojen TsaoGeorge W Holcomb
Oct 22, 2008·Annals of Surgery·UNKNOWN SCOAP CollaborativeRichard Thirlby
Dec 2, 2008·Journal of Pediatric Surgery·Shawn D St PeterDaniel J Ostlie

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Citations

Jul 11, 2013·World Journal of Gastroenterology : WJG·Jenny Tannoury, Bassam Abboud
Jan 15, 2014·Emergency Radiology·Kara Gaetke-UdagerSuntrea G Hammer
Feb 2, 2016·Seminars in Ultrasound, CT, and MR·Francesca IacobellisMariano Scaglione
Apr 10, 2012·The Journal of Surgical Research·Corey W IqbalShawn D St Peter
Nov 26, 2013·The British Journal of Surgery·M M N LeeuwenburghUNKNOWN OPTIMAP study group
May 13, 2015·The British Journal of Surgery·J J AtemaM A Boermeester
Oct 16, 2016·Pediatric Surgery International·Rebecca M RenteaCharles L Snyder
Oct 31, 2016·International Journal of Surgery·Byeong Geon JeonSang-Jeon Lee
Nov 20, 2019·The Cochrane Database of Systematic Reviews·Bo RudPeer Wille-Jørgensen
Feb 27, 2015·World Journal of Gastroenterology : WJG·Sang Chul LeeSay-June Kim

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