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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
Summary
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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