[Diagnostic value of computerized tomography in acute appendicitis in adults]

The diagnosis of acute appendicitis is generally based on clinical and laboratory findings. In 1/3 of the cases, acute appendicitis presents atypically and, consequently, the contribution of the radiologist becomes necessary. Conventional radiologic methods, i.e. plain abdominal film and barium enema, generally yield aspecific and indirect information. In contrast, the modern methods of cross-sectional imaging, i.e. sonography and Computed Tomography (CT), allow to identify, directly and accurately, the inflammation of appendix and periappendiceal tissues. We report our experience with 25 cases of surgically confirmed adult acute appendicitis studied with abdominal CT examination. CT was usually performed with contiguous 5-mm-thick scans and with oral and intravenous contrast agent administration. CT showed abnormal appendix (72% of cases), pericecal or periappendiceal inflammatory infiltration (68%), phlegmon (20%), appendicoliths (16%), abscess (12%). CT was diagnostic for appendicitis in 21 cases (84%) and suggestive of it in 4 cases (16%). CT is an interesting diagnostic alternative to US in the assessment of clinically questionable cases of appendicitis. Furthermore, it is the method of choice in the analysis of complicated appendicitis and in the percutaneous management of periappendiceal abscesses.