Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Preoperative CT useful for younger women with suspected appendicitis

26.01.2010
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."

"Making the Diagnosis of Acute Appendicitis: Do More Preoperative CT Scans Mean Fewer Appendectomies? A 10-year Study." 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.

Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc. (http://radiology.rsnajnls.org/)

RSNA is an association of more than 44,000 radiologists, radiation oncologists, medical physicists and related scientists committed to excellence in patient care through education and research. (RSNA.org)

For patient-friendly information on CT, visit RadiologyInfo.org.

Linda Brooks | EurekAlert!
Further information:
http://www.rsna.org
http://RadiologyInfo.org

More articles from Medical Engineering:

nachricht Visualizing gene expression with MRI
23.12.2016 | California Institute of Technology

nachricht Illuminating cancer: Researchers invent a pH threshold sensor to improve cancer surgery
21.12.2016 | UT Southwestern Medical Center

All articles from Medical Engineering >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Quantum optical sensor for the first time tested in space – with a laser system from Berlin

For the first time ever, a cloud of ultra-cold atoms has been successfully created in space on board of a sounding rocket. The MAIUS mission demonstrates that quantum optical sensors can be operated even in harsh environments like space – a prerequi-site for finding answers to the most challenging questions of fundamental physics and an important innovation driver for everyday applications.

According to Albert Einstein's Equivalence Principle, all bodies are accelerated at the same rate by the Earth's gravity, regardless of their properties. This...

Im Focus: Traffic jam in empty space

New success for Konstanz physicists in studying the quantum vacuum

An important step towards a completely new experimental access to quantum physics has been made at University of Konstanz. The team of scientists headed by...

Im Focus: How gut bacteria can make us ill

HZI researchers decipher infection mechanisms of Yersinia and immune responses of the host

Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...

Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Sustainable Water use in Agriculture in Eastern Europe and Central Asia

19.01.2017 | Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

 
Latest News

Tracking movement of immune cells identifies key first steps in inflammatory arthritis

23.01.2017 | Health and Medicine

Electrocatalysis can advance green transition

23.01.2017 | Physics and Astronomy

New technology for mass-production of complex molded composite components

23.01.2017 | Process Engineering

VideoLinks
B2B-VideoLinks
More VideoLinks >>>