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CT Scans Reduce Unneeded Appendectomies in Women
Date:1/28/2010

Procedure helps avoid misdiagnosis in those under 45

THURSDAY, Jan. 28 (HealthDay News) -- Using computed tomography (CT) scans to assess younger women with suspected acute appendicitis may help reduce unnecessary surgeries, a new study shows.

"We found that rising utilization of CT over the past decade, along with advances in CT technology, coincided with a significant decrease in negative appendectomies among women 45 years and younger," Dr. Courtney A. Coursey, a radiologist at Emory University in Atlanta, said in a news release. She co-wrote the study while a radiology fellow at Duke University Medical Center in Durham, N.C.

Coursey and colleagues reviewed the medical records of 925 patients who underwent urgent appendectomy at Duke between January 1998 and September 2007. Over that time, the number of patients who had preoperative CT increased, from 18.5 percent to 93.2 percent.

This increased use of preoperative CT coincided with a decrease in the rate of negative (unnecessary) appendectomies among women aged 45 or younger -- from 42.9 percent in 1998 to 7.1 percent in 2007.

However, increased preoperative CT use didn't lead to a lower negative appendectomy rate in men or in women older than 45. This may be because these groups already had low unnecessary appendectomy rates compared to women younger than 45, whose rates of negative appendectomy are generally higher because of gynecologic factors that can make it difficult to diagnose appendicitis. For example, ovarian cysts can cause lower abdominal pain that's similar to appendicitis.

"CT is a very useful test for women 45 years and younger based on the overall trends we observed during the 10-year period," Coursey said.

The study appears in the February issue of Radiology.

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