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Does CT Reduce the Rate of Negative Laparoscopies for Acute Appendicitis? A Single-Center Retrospective Study.
Wagner, Pedro de J Haroon, Muthana Morarasu, Stefan Eguare, Emmanuel Al-Sahaf, Osama
Wagner, Pedro de J
Haroon, Muthana
Morarasu, Stefan
Eguare, Emmanuel
Al-Sahaf, Osama
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Date
2020-01
Date Submitted
Keywords
Acute appendicitis
CT scan
laparoscopy
CT scan
laparoscopy
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Start Date
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Principal Investigators
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JMedLife-13-26.pdf
Adobe PDF, 444.59 KB
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Abstract
In surgical practice, surgeons request CT scans to rule out acute appendicitis, even in young patients. We aimed to assess the feasibility of using a CT scan to reduce the rate of negative laparoscopies in patients younger than 40 with equivocal signs of acute appendicitis. Therefore, we conducted a retrospective observational study on the patients admitted with a provisional diagnosis of acute appendicitis. Patients younger than 40 and with the Alvarado score between 3 and 6 were included. These were divided into two groups: those who had or did not have a CT scan. Each group was further subdivided into patients that had a laparoscopy and those that did not. Out of 204 patients included in the study, 16% were included in the CT group, and 84% in the non-CT group. 71.9% of the patients that underwent a CT scan had appendicitis and underwent an appendectomy. Five patients with a normal CT scan had appendectomy due to persistent signs of acute appendicitis. The histopathology of the 23 patients with positive CT was positive, and 3 of the 5 patients with negative CT that underwent appendectomy had positive histology results. The negative appendectomy rate for patients that had preoperative CT is 7.14% compared to 32.4% in patients without preoperative CT. The rate of negative laparoscopy in patients younger than 40 years old that undergo preoperative CT is significantly lower with a p-value of .00667.
Language
en
Citation
ISSN
eISSN
1844-3117
ISBN
DOI
10.25122/jml-2019-0099
PMID
32341697