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Appendiceal outer diameter as an indicator for differentiating appendiceal mucocele from appendicitis

Wan-Ching Lien1, Shih-Pei Huang, Chun-Lin Chi

  • 1Department of Emergency Medicine, College of Medicine, National Taiwan University and National Taiwan University Hospital, Taipei 100, Taiwan.

The American Journal of Emergency Medicine
|November 14, 2006
PubMed
Abstract

Insights

Appendiceal mucocele (AM) can mimic appendicitis. Sonographic outer diameter ≥15 mm effectively differentiates AM from appendicitis, aiding preoperative diagnosis and treatment planning.

Area of Science:

  • Gastroenterology
  • Radiology
  • Surgical Pathology

Background:

  • Appendiceal mucocele (AM) often presents with symptoms similar to acute appendicitis.
  • Accurate preoperative diagnosis is essential for appropriate emergency department management.
  • Differentiating AM from appendicitis preoperatively can guide treatment decisions.

Purpose of the Study:

  • To identify clinical and sonographic features distinguishing appendiceal mucocele (AM) from acute appendicitis.
  • To evaluate the utility of sonographic measurements in preoperative differentiation.

Main Methods:

  • A case-control study compared 16 patients with histologically confirmed AM to 64 age- and sex-matched patients with appendicitis.
  • Conditional logistic regression analyzed clinical and sonographic parameters.
  • Odds ratios (OR) and 95% confidence intervals (CI) were calculated.

Main Results:

  • Sonographic appendiceal outer diameter positively correlated with AM (OR, 2.31).
  • Right lower quadrant pain was negatively correlated with AM (OR, 0.38).
  • An outer diameter ≥15 mm demonstrated 83% sensitivity and 92% specificity for AM.

Conclusions:

  • Appendiceal outer diameter measured by sonography is a valuable preoperative tool.
  • A threshold of 15 mm for outer diameter effectively differentiates AM from acute appendicitis.

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