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Preoperative CT useful for younger women with suspected appendicitis
Date:1/26/2010

OAK BROOK, Ill. Preoperative computed tomography (CT) may help reduce unnecessary surgeries in women of reproductive age with suspected acute appendicitis, according to a new study appearing in the February issue of the journal Radiology.

"We found that rising utilization of preoperative 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," said Courtney A. Coursey, M.D., a radiologist at Emory University in Atlanta, who co-authored this study while a radiology fellow at Duke University Medical Center in Durham, N.C.

Acute appendicitis is inflammation of the appendix, a fingerlike organ attached to the large intestine in the lower right area of the abdomen. An inflamed appendix can perforate, resulting in a life-threatening infection.

While surgical removal of the appendix is the common treatment for acute appendicitis, diagnosis is not always clear clinically. Prior to the advent of CT, in inconclusive cases, physicians would often remove the appendix as a precaution. Historically, this resulted in a high rate of negative appendectomies with negative appendectomy rates of 20 percent to 25 percent and as high as 40 percent in women considered acceptable. Negative appendectomy rates are generally higher in women due to gynecologic pathology that can confound appendicitis diagnosis. For instance, symptomatic ovarian cysts can cause lower abdominal pain similar to that from appendicitis.

CT is now often used in the evaluation of suspected appendicitis and has the potential to reduce the negative appendectomy rate. An acutely inflamed appendix appears thick-walled on CT, and adjacent inflammatory changes are often visible. If the appendix is perforated, fluid next to the appendix may be visible on CT.

There have been contradictory reports in the medical literature regarding whether or not the increased u
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Contact: Linda Brooks
lbrooks@rsna.org
630-590-7762
Radiological Society of North America
Source:Eurekalert

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