Navigation Links
Appendectomy may be best for patients with positive CT exam
Date:5/25/2010

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 removed within four days. Ninety-five percent of those cases were confirmed as acute appendicitis.

Forty-nine (10%) of 516 patients had nonsurgical treatment, including antibiotics or percutaneous abscess drainage. An additional four of 516 patients were lost to follow up.

Thirteen (three percent) of the 516 patients with positive CT findings did not receive immediate surgical treatment because their symptoms including a normal appetite, absence of nausea and vomiting, normal white blood cell count and mild or resolving pain were atypical for acute appendicitis. Of those, five (38 percent) ultimately had their appendix removed after seeking treatment for the same symptoms an average of four months later. Appendicitis was confirmed in all cases.

"The results of our study confirm that CT is a good diagnostic tool for appendicitis and that surgeons should be wary of dismissing positive CT findings," Dr. Webb said. "Prompt treatment of chronic or recurrent appendicitis can prevent patients from developing complications or other future ill effects."

The study's findings may also help explain the disparity between CT results that indicate appendicitis and patient symptoms that do not.

"When the appendix is not completely obstructed, it can result in a milder form of appendicitis that is chronic or recurring," Dr. Webb said. "But the three forms of appendicitis, acute, chronic and recurrent, are indistinguishable on CT scans.


'/>"/>

Contact: Linda Brooks
lbrooks@rsna.org
630-590-7762
Radiological Society of North America
Source:Eurekalert

Related medicine news :

1. Targeted therapy prolongs life in patients with HER2-positive breast cancer
2. Aspen Dental Opens 44 New Offices, Welcomes 340,000 New Patients in 2009
3. Blood Thinner Combos Risky for Heart Attack Patients
4. Patients with mild gallstone pancreatitis can undergo surgery sooner, shortening hospital stays
5. Brain Scans Suggest Some Vegetative Patients May Be Aware
6. Inflammation marker related to obesity is elevated in patients with pancreatic cancer
7. Adding Chemo to Tamoxifen Helps Some Breast Cancer Patients
8. Livonia Optometrist Offers New Technology - and New Hope - to Patients ... Free of Charge
9. HD For More Than Your TV – New Technologies Offer Patients High Definition Vision At Any Age
10. Molecule Discovery Might Help ALS Patients
11. Most Hospital Patients Dont Know What Meds Theyre Taking
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/22/2017)... ... 22, 2017 , ... The Waismann Method® is providing a faster, ... recently fallen victim to America’s opioid epidemic. Now, opiate dependent individuals can be treated ... free from the shame, stigma, and harmful labeling believed to prevent many ...
(Date:2/22/2017)... ... February 22, 2017 , ... The National Academy of Certified ... the April 2017 testing period. NACCM, a nonprofit organization, has provided the premier ... exam is periodically re-calibrated to ensure that newly certified professionals are prepared to ...
(Date:2/22/2017)... ... February 22, 2017 , ... Giving ... fewer trips the emergency room, fewer hospital admissions, and better blood pressure and ... Care® (AJMC®) finds. The study can be found here . , The ...
(Date:2/22/2017)... ... 2017 , ... In a 2012 survey, over a quarter ... a prescription because they could not afford to pay for it. Among those ... At the same time, hospitals, pharmacies, manufacturers and nursing homes dispose ...
(Date:2/22/2017)... Los Angeles, CA (PRWEB) , ... February 22, 2017 , ... ... with the recent addition of esteemed ophthalmologist, Dr. Steven H. Rauchman, practicing at ... are common in auto accidents, product liability, premise liability and other personal injury cases. ...
Breaking Medicine News(10 mins):
(Date:2/23/2017)... , February 23, 2017 ... report on the global market for intraoperative imaging, ... presently valued at US$ 513.9 million. According to ... keep surging on the grounds of increasing adoption ... the field of diagnostic imaging for neurosurgeries. The ...
(Date:2/23/2017)... The top three players dominating ... Koninklijke Philips N.V., and Schiller. Collectively, these companies held ... in 2015. Strong product portfolio and a monumental geographical ... aiding these players remain leaders in the fragmented competitive ... the global market are likely to focus on mergers ...
(Date:2/23/2017)... On Wednesday, February 22, 2017, US markets saw ... sectors finished the trading sessions in green, four closed in ... indices were also mixed at the close of yesterday,s session. ... by 0.09%; the Dow Jones Industrial Average edged 0.16% higher, ... 2,362.82, down 0.11%. This Thursday morning, Stock-Callers.com looks at the ...
Breaking Medicine Technology: