Computed tomography scan with colorectal contrast is an effective method for diagnosing appendicitis, and should be performed in all suspected cases of appendicitis, according to a team from Colorado, USA.
The team compared the use of the computed tomography (CT) scan with standard management in diagnosing appendicitis. They reported their findings in the December issue of the American Journal of Surgery.
The researchers conducted a prospective randomized study of patients who received general surgery consultation for appendicitis.
Patients were randomized to receive CT scan with colorectal contrast or standard management. The standard management varied from observation with serial abdominal examinations, to right lower quadrant ultrasound, to immediate operation.
A total of 65 patients were enrolled in the CT scan group and 63 patients in the standard management group.
|Sensitivity, specificity, and accuracy of diagnostic methods:|
94%, 100%, 96%
100%, 79%, 89%
|American Journal of Surgery|
The sensitivity, specificity, and accuracy of CT scan were found to be 94%, 100%, and 96%, respectively.
The team reported that a CT scan positively altered the management in 26% of cases, and made alternative diagnoses in 14%.
The sensitivity, specificity, and accuracy of the standard management group were 100%, 79%, and 89%, respectively. This group had a negative appendectomy rate of 19%.
Researcher Susan Walker, of the Exempla Saint Joseph Hospital, Denver, Colorado, concluded on behalf of the group, "CT scan with rectal contrast is an effective method for diagnosing appendicitis and should be performed in all patients suspected of having appendicitis."