Multidetector computed tomography (MDCT) use enables physicians to effectively identify which patents with suspected appendicitis have the condition and require surgery, according to a study appearing today in the Annals of Internal Medicine. Although MDCT is currently used in up to 90% of suspected adult appendicitis cases, its effectiveness in finding the condition or ruling it out had not been rigorously studied.
Appendicitis is the most common condition requiring urgent or emergency abdominal surgery, and fast diagnosis of the condition followed by surgery to remove the inflamed appendix is important for minimizing complications—including rupture of the appendix, an event that can have fatal consequences. Proper assessment is also important in ruling out appendicitis so that patients who do not actually have the condition can be spared unnecessary surgery.
In the new study, researchers from the University of Wisconsin School of Medicine and Public Health in Madison found that MDCT was highly accurate in assessing suspected appendicitis in men and women. The findings are based on 2871 adult patients who underwent MDCT for suspected appendicitis from January 2000 through December 2009 at a single academic medical center.
Of the 708 patients identified with MDCT as probably having appendicitis, 665 were ultimately found to have the condition (94%) and 43 patients were falsely identified as having appendicitis (6%), 23 of whom underwent unnecessary surgery. Of the 2163 patients in whom MDCT imaging indicated that they did not have appendicitis, 2153 were confirmed as not having appendicitis (99.5%); 10 patients had been misidentified (0.5%) and were actually experiencing appendicitis.
The findings, along with recent data from other sources, support the “routine use of preoperative MDCT as the standard of care for suspected appendicitis in adults,” the researchers concluded.