Featured Research

from universities, journals, and other organizations

Preoperative CT useful for younger women with suspected appendicitis

Date:
January 26, 2010
Source:
Radiological Society of North America
Summary:
Preoperative computed tomography may help reduce unnecessary surgeries in women of reproductive age with suspected acute appendicitis, according to a new study.

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."

Collaborating on this paper with Dr. Coursey were Rendon C. Nelson, M.D., Mayur B. Patel, M.D., Courtney Cochran, B.S.R.T., R.D.M.S., Leslie G. Dodd, M.D., David M. DeLong, Ph.D., Craig A. Beam, Ph.D., and Steven Vaslef, M.D., Ph.D.


Story Source:

The above story is based on materials provided by Radiological Society of North America. Note: Materials may be edited for content and length.


Journal Reference:

  1. Coursey et al. Making the Diagnosis of Acute Appendicitis: Do More Preoperative CT Scans Mean Fewer Negative Appendectomies? A 10-year Study. Radiology, 2010; 254 (2): 460 DOI: 10.1148/radiol.09082298

Cite This Page:

Radiological Society of North America. "Preoperative CT useful for younger women with suspected appendicitis." ScienceDaily. ScienceDaily, 26 January 2010. <www.sciencedaily.com/releases/2010/01/100126083124.htm>.
Radiological Society of North America. (2010, January 26). Preoperative CT useful for younger women with suspected appendicitis. ScienceDaily. Retrieved April 19, 2014 from www.sciencedaily.com/releases/2010/01/100126083124.htm
Radiological Society of North America. "Preoperative CT useful for younger women with suspected appendicitis." ScienceDaily. www.sciencedaily.com/releases/2010/01/100126083124.htm (accessed April 19, 2014).

Share This



More Health & Medicine News

Saturday, April 19, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

'Holy Grail' Of Weight Loss? New Find Could Be It

'Holy Grail' Of Weight Loss? New Find Could Be It

Newsy (Apr. 18, 2014) In a potential breakthrough for future obesity treatments, scientists have used MRI scans to pinpoint brown fat in a living adult for the first time. Video provided by Newsy
Powered by NewsLook.com
Little Progress Made In Fighting Food Poisoning, CDC Says

Little Progress Made In Fighting Food Poisoning, CDC Says

Newsy (Apr. 18, 2014) A new report shows rates of two foodborne infections increased in the U.S. in recent years, while salmonella actually dropped 9 percent. Video provided by Newsy
Powered by NewsLook.com
Scientists Create Stem Cells From Adult Skin Cells

Scientists Create Stem Cells From Adult Skin Cells

Newsy (Apr. 17, 2014) The breakthrough could mean a cure for some serious diseases and even the possibility of human cloning, but it's all still a way off. Video provided by Newsy
Powered by NewsLook.com
Obama: 8 Million Healthcare Signups

Obama: 8 Million Healthcare Signups

AP (Apr. 17, 2014) President Barack Obama gave a briefing Thursday announcing 8 million people have signed up under the Affordable Care Act. He blasted continued Republican efforts to repeal the law. (April 17) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins