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Tomography refers to imaging by sections. Computed tomography (CT) is a non-invasive imaging technique that uses computers to analyze several cross-sectional X-rays to reveal minute details about structures in the body.
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Is there a role for abdominal computed tomographic scans in appendicitis?

J G Schuler¹, M J Shortsleeve, R S Goldenson

¹Department of Surgery, Mount Auburn Hospital, Cambridge, Mass 02238, USA.

Archives of Surgery (Chicago, Ill. : 1960)

|May 23, 1998

Summary

Abdominal computed tomographic scanning (ACTS) accurately diagnoses appendicitis, with a 96% overall accuracy. This imaging modality significantly benefits patients by reducing unnecessary surgeries and improving diagnostic outcomes.

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Area of Science:

Radiology
Gastroenterology
Surgical Diagnostics

Background:

Appendicitis diagnosis can be challenging, particularly in patients with indeterminate clinical findings.
Traditional diagnostic methods may lead to delays or unnecessary surgical interventions.

Purpose of the Study:

To evaluate the diagnostic effectiveness of abdominal computed tomographic scanning (ACTS) in adult patients with suspected appendicitis.
To assess the impact of ACTS on negative appendectomy rates and overall patient management.

Main Methods:

Retrospective analysis of 97 adult patients with appendicitis in their differential diagnosis.
Patients included those with insufficient clinical findings for immediate surgical decision or discharge.
Data collected over a 14-month period at a community teaching hospital.

Main Results:

ACTS demonstrated high accuracy: 96% overall, with 92% positive predictive value and 98% negative predictive value.
The negative appendectomy rate in the ACTS group was 5.8%, significantly lower than the hospital's prior rate of 14%.
ACTS provided definitive diagnoses or alternative diagnoses in 57.7% of patients, influencing treatment decisions.

Conclusions:

Abdominal computed tomographic scanning is an accurate and beneficial tool for diagnosing appendicitis in clinically indeterminate cases.
Selective use of ACTS can reduce negative appendectomy rates and hospital admissions for observation.
Predicting which specific patients will benefit most from ACTS remains an area for further investigation.