Barium appendicitis: A single institution review in Japan

Area of Science:

• Medical Imaging
• Gastroenterology
• Radiology

Background:

• Appendicitis is a common surgical emergency.
• Barium studies, used for gastrointestinal imaging, may lead to a rare form of appendicitis.
• Distinguishing barium appendicitis from other forms is crucial for appropriate management.

Purpose of the Study:

• To review clinical experience with barium appendicitis.
• To evaluate the utility of computed tomography (CT) scan radiodensity in diagnosing barium appendicitis.

Main Methods:

• Retrospective review of 396 patients with acute appendicitis from 2013-2015.
• Identified 12 patients meeting criteria for barium appendicitis (appendicitis diagnosis, prior barium study, high-density material in appendix on CT).
• Measured CT scan radiodensity (Hounsfield units) of appendiceal material in barium appendicitis and non-barium fecaliths.

Main Results:

• Barium appendicitis occurred in 3.0% of patients with acute appendicitis.
• Median CT radiodensity in barium appendicitis was significantly higher (10000.8 HU) than in non-barium fecaliths (393.1 HU).
• CT radiodensity measurement effectively differentiated barium appendicitis from routine appendicitis.

Conclusions:

• Barium appendicitis is a notable clinical entity, particularly in regions with frequent barium studies.
• CT scan radiodensity is a valuable metric for differentiating barium appendicitis from other causes of appendicitis.
• This finding aids in diagnosis and patient management.