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Is acute appendicitis still misdiagnosed?
Marius Kryzauskas1, Donatas Danys1, Tomas Poskus1
1Vilnius University Hospital Santariskiu Klinikos, Santariskiu Street 2, LT-08661, Vilnius, Lithuania.
Open Medicine (Warsaw, Poland)
|March 30, 2017
Summary
Diagnosing acute appendicitis remains difficult, leading to a high rate of negative appendectomies. Further investigations like observation and computed tomography scans are recommended to improve diagnostic accuracy and prevent unnecessary surgeries.
Area of Science:
- Surgical diagnostics
- Gastrointestinal surgery
- Emergency medicine
Background:
- Acute appendicitis diagnosis presents challenges, with a significant rate of negative appendectomies due to misdiagnosis.
- Negative appendectomy, an unnecessary surgery for non-inflamed appendix, highlights diagnostic inefficiencies.
Purpose of the Study:
- To evaluate the effectiveness of preoperative investigations in reducing negative appendectomies for suspected acute appendicitis.
Main Methods:
- Retrospective analysis of 554 adult patients undergoing surgery for suspected appendicitis (2008-2013).
- Comparison of preoperative data, investigations, and outcomes between patients with normal appendix (Group A) and inflamed appendix (Group B).
Main Results:
- Elevated hemoglobin, hematocrit, and white blood cell counts were significant indicators for inflamed appendix (Group B).
- Ultrasonography showed no statistically significant diagnostic value.
- Alvarado score was less than 7 in more patients with normal appendix (Group A).
Conclusions:
- Acute appendicitis diagnosis remains challenging, with a persistent high rate of negative appendectomies.
- Computed tomography and extended observation are suggested as additional tools to enhance diagnostic accuracy and minimize unnecessary surgeries.
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