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Diagnostic performance of CT findings in differentiation of perforated from nonperforated appendicitis

Wanwarang Suthikeeree1, Lassanun Lertdomrongdej, Apinya Charoensak

  • 1Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. ampwanwarangs@yahoo.com

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|February 25, 2011
PubMed

Insights

Multidetector row computed tomography (MDCT) effectively differentiates perforated from non-perforated appendicitis. Key CT findings like abscess and extraluminal appendicolith show high specificity for perforation, aiding diagnosis.

Area of Science:

  • Radiology
  • Medical Imaging
  • Gastrointestinal Surgery

Background:

  • Acute appendicitis is a common surgical emergency.
  • Accurate differentiation between perforated and non-perforated appendicitis is crucial for appropriate patient management.
  • Computed tomography (CT) is a widely used imaging modality for diagnosing appendicitis.

Purpose of the Study:

  • To evaluate the diagnostic performance of multidetector row computed tomography (MDCT) findings in distinguishing perforated from non-perforated appendicitis.
  • To determine the accuracy of individual CT findings in this differentiation.

Main Methods:

  • Retrospective review of 48 adult patient CT scans with confirmed acute appendicitis.
  • Two radiologists assessed CT findings, comparing them with pathological or surgical outcomes.
  • Analysis included sensitivity, specificity, and accuracy of various CT indicators.

Main Results:

  • CT findings of abscess, extraluminal appendicolith, and extraluminal air demonstrated high specificity (95.24%-100%) for perforated appendicitis.
  • Defect in appendiceal wall enhancement showed the highest accuracy.
  • Enlarged mesenteric lymph nodes and appendiceal wall enhancement defects had high sensitivity (88.46%-88.88%).

Conclusions:

  • MDCT is a valuable tool for differentiating perforated from non-perforated appendicitis.
  • Specific CT findings significantly aid in diagnosing appendiceal perforation.
  • Combined CT findings offer improved diagnostic accuracy and sensitivity.
Abstract

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