Can negative appendectomy rate be decreased by using spiral computed tomography without contrast material?

Area of Science:

• Medical Imaging
• Surgical Diagnosis
• Emergency Medicine

Background:

• Diagnostic errors in acute appendicitis range from 15-20%, necessitating improved diagnostic methods.
• Computed Tomography (CT) has emerged as a promising tool for diagnosing acute appendicitis due to its high sensitivity and specificity.

Purpose of the Study:

• To investigate the impact of Computed Tomography (CT) on the diagnosis of acute appendicitis.
• To evaluate the effect of CT on the negative appendectomy rate in patients with suspected appendicitis.

Main Methods:

• A retrospective analysis of 65 patients with suspected acute appendicitis who underwent non-contrast spiral CT.
• Correlation of CT findings with surgical operation reports, pathology results, and clinical follow-up for non-operated patients.
• Surgeons made the final decision for appendectomy based on clinical evaluation, laboratory results, and CT imaging.

Main Results:

• CT demonstrated a sensitivity of 93.3% and a specificity of 85% in diagnosing acute appendicitis.
• The study identified 42 true positive, 3 false positive, 17 true negative, and 3 false negative CT results.
• The negative appendectomy rate was reduced to 6.25% among the 48 patients who underwent surgery.

Conclusions:

• Computed Tomography (CT) is a valuable tool for diagnosing acute appendicitis, improving diagnostic accuracy.
• Integrating CT scans with clinical judgment can significantly decrease the negative appendectomy rate.
• CT imaging aids in optimizing surgical decisions for suspected acute appendicitis, reducing unnecessary procedures.