OAK BROOK, Ill. When CT results suggest appendicitis, but a patient's symptoms are inconsistent with the acute condition, physicians should consider a diagnosis of chronic or recurrent appendicitis and surgical treatment, according to a new study published in the online edition and July printed issue of the journal Radiology.
"The decision to forego surgery in these patients often results in missed appendicitis, with a possible increased risk of perforation," said study co-author Emily M. Webb, M.D., assistant professor of clinical radiology at the University of California, San Francisco.
Acute appendicitis, which occurs when the appendix a small, tube-like structure attached to the large intestine becomes blocked and inflamed, requires prompt surgical removal. Left untreated, an inflamed appendix will eventually perforate, or burst, spilling infectious materials into the abdominal cavity, which can be life-threatening. In the less common chronic and recurrent appendicitis, patients experience milder symptoms that may come and go. According to the National Institutes of Health, appendicitis can affect anyone, but is more common among people 10 to 30 years old. Appendicitis leads to more emergency abdominal surgeries than any other cause.
For the study, the researchers reviewed CT reports and medical records of 2,283 patients who underwent CT for suspected appendicitis at the University of California, San Francisco Medical Center between 2002 and 2007. Patients in the study included 856 men and 1,427 women between the ages of 18 and 99 years old with a mean age of 46.
"We wanted to look at patients with a positive CT scan but atypical clinical symptoms who did not have their appendix immediately removed," Dr. Webb said.
Of the study's 2,283 patients, 516, or 23 percent, had CT findings that indicated a probable or definite appendicitis. Of those 516 patients, 450 (87 percent) had their appendix surgically re
|Contact: Linda Brooks|
Radiological Society of North America