Navigation Links
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 use of CT has resulted in a lower negative appendectomy rate. To determine the impact of CT on negative appendectomy rates, Dr. Coursey and colleagues reviewed a surgical database of 925 patients who underwent urgent appendectomy at Duke between January 1998 and September 2007.

The percentage of patients who had preoperative CT increased significantly over the 10-year period, from 18.5 percent in 1998 to 93.2 percent in 2007. The increased use of CT corresponded with a lower negative appendectomy rate for women age 45 years or younger. The negative appendectomy rate among those women dropped from 42.9 percent in 1998 to 7.1 percent in 2007. The shift from single- detector CT to multidetector CT and other advances in CT technology also correlated with a reduction in false-positive diagnoses.

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

Increased use of preoperative CT at Duke did not coincide with a lower negative appendectomy rate in men, regardless of age, or in women older than 45 years. Dr. Coursey suggested that the lack of a decline might be attributable to a very low negative appendectomy rate in those groups at the beginning of the study period.

"Although it's a terrific test, CT and our interpretation of CT images are not 100 percent perfect," Dr. Coursey said. "Therefore, it may be difficult to improve significantly upon diagnosis in groups with an already low negative appendectomy rate."


'/>"/>

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

Related medicine news :

1. Quicker Referral for Gallbladder Operation Could Save 50 Percent of Preoperative Treatment Charges
2. Preoperative MR may assist surgeons in nerve sparing during robotic prostatectomy
3. Preoperative radiation may improve survival rates in advanced rectal cancer patients
4. Preoperative assessment of cancer patients enables early diagnosis, treatment of lymphedema
5. Kinetic variable most useful for identifying malignant MRI-detected breast lesions identified
6. Research finds photos more useful than words
7. Cellular target may prove useful in treating deadly brain tumors
8. Green chemistry could ease manufacture, boost usefulness of cancer drug
9. Study shows that maintenance rituximab is useful for advanced indolent lymphoma
10. A useful method to diagnose chest pain with foregut symptoms
11. Systolic and diastolic blood pressures together more useful for predicting cardiovascular risk
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/27/2017)... ... May 26, 2017 , ... A May 8 ... a doctor for colds or respiratory issues that are not responsive to antibiotics nevertheless ... on doctors may be largely responsible for the problem both in Canada and the ...
(Date:5/26/2017)... ... May 26, 2017 , ... Mediaplanet is proud to ... campaign in USA Today, which will educate readers on how to take care of ... a large focus is placed on melanoma. Dancing with the Stars professional, Witney Carson, ...
(Date:5/26/2017)... Calif. (PRWEB) , ... May 26, 2017 , ... ... the integration of the CareFusion NOX-T3 portable sleep monitor with its Somnoware Sleep ... a consistent, browser-based interface for diagnostic device operations. With this platform, initializing devices ...
(Date:5/26/2017)... (PRWEB) , ... May 26, 2017 , ... After raising ... Antzy Top gadget will continue to be available at a discounted crowdfunding price on ... with stress wherever they are, I also wanted to bring a fidget toy to ...
(Date:5/26/2017)... ... May 26, 2017 , ... “When the Stars Lead Home”: a poignant ... of published author Laura Weigel Douglas, an avid reader who lives in the Pacific ... sometimes feels like Green Hills Adventure Camp. She couldn’t be more grateful. , Twelve-year ...
Breaking Medicine News(10 mins):
(Date:5/4/2017)... WAYNE, Pa. , May 4, 2017 /PRNewswire/ ... made from thermoplastics and other highly-engineered materials, is ... Microextrusion tubing has been developed in recent ... neurovascular interventional therapies and surgical applications. More expensive ... used to produce microextrusion tubing due to their ...
(Date:5/3/2017)... Calif. , May 3, 2017 ... of any hospital or healthcare facility. Commonly referred ... room is equipped with diagnostic imaging technology to ... of the heart. In these spaces, a team ... catheterization, balloon angioplasty, percutaneous coronary intervention, congenital heart ...
(Date:5/3/2017)... N.J. , May 3, 2017  Getinge, ... that contribute to quality enhancement and cost efficiency ... from a study of contemporary practice demonstrating that ... first-line therapy for critically ill patients. The single-center, ... Company,s newer large volume MEGA ® 50cc ...
Breaking Medicine Technology: