Surgical validation of unenhanced helical computed tomography in acute appendicitis

The British Journal of Surgery
K H in't HofG Kazemier

Abstract

Surgery for pain in the right lower quadrant of the abdomen remains a clinical dilemma. This prospective study assessed the accuracy of preoperative unenhanced helical computed tomography (CT) in the evaluation of patients with suspected acute appendicitis. One hundred and three adult patients with suspected acute appendicitis underwent unenhanced helical CT of the abdomen. Subsequently, all patients underwent laparoscopic inspection of the abdominal cavity by a surgeon who was blinded to the diagnosis suggested by CT. Patients underwent appropriate surgical therapy accordingly. Follow-up was at least 6 weeks. Appendicitis was diagnosed by CT in 83 patients (80.6 per cent). Acute appendicitis was identified during laparoscopy in 87 patients (84.5 per cent). Prospective interpretation of CT images yielded a sensitivity of 95.4 per cent and a specificity of 100 per cent for the diagnosis of acute appendicitis. There were four false-negative scans. In 12 of 20 patients without signs of appendicitis on CT, the scan established the presence of other pathology. At operation no additional pathology was observed in this group and all other diagnoses proved to be correct. Plain helical CT in patients with suspected acute appendicitis pr...Continue Reading

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Citations

Aug 19, 2007·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Sandeepa MusunuruSharon M Weber
Oct 19, 2013·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Ira BacharBoris Kirshtein
Nov 2, 2007·Australasian Radiology·T MenonS Rao
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Jan 8, 2010·World Journal of Surgery·Brian C HillAnthony J Senagore
Jan 23, 2016·The British Journal of Radiology·Helen PerryWyn G Lewis
Dec 5, 2013·Advances in Surgery·Frederick Thurston Drake, David Reed Flum
Apr 8, 2011·The Journal of Surgical Research·Carrie A LaituriShawn D St Peter
Feb 2, 2010·Annals of Emergency Medicine·John M HowellUNKNOWN American College of Emergency Physicians
Sep 8, 2009·Annals of Emergency Medicine·Veronica HlibczukMichael D Brown
Jul 12, 2013·The British Journal of Surgery·UNKNOWN National Surgical Research Collaborative
Nov 20, 2019·The Cochrane Database of Systematic Reviews·Bo RudPeer Wille-Jørgensen

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