Pitfalls and mimickers at 64-section helical CT that cause negative appendectomy: an analysis from 1057...

Area of Science:

• Radiology
• Surgical Pathology

Background:

• Acute appendicitis is a common surgical emergency.
• Negative appendectomy, or removal of a healthy appendix, can lead to unnecessary morbidity.
• Advancements in imaging aim to improve diagnostic accuracy for appendicitis.

Purpose of the Study:

• To ascertain the rate of negative appendectomy following 64-section helical CT scans.
• To identify the contributing factors to negative appendectomies in patients with suspected appendicitis.

Main Methods:

• Retrospective analysis of 1057 patients who underwent appendectomy after 64-section helical CT.
• Detailed review of CT scans and clinical, operative, and histopathological data for negative appendectomy cases.

Main Results:

• A negative appendectomy rate of 1.7% (18/1057) was observed.
• In most negative appendectomy cases (72%), CT findings mimicked acute appendicitis.
• Interpretive errors in initial radiology reports occurred in 28% of negative appendectomy cases.

Conclusions:

• Preoperative 64-section helical CT is effective in minimizing negative appendectomy rates.
• CT findings can be misleading, even with advanced imaging, leading to some negative appendectomies.
• Reducing interpretive errors in radiology reports is crucial for further improving diagnostic accuracy.