Role of Contrast Enhanced Abdominal Computed Tomography in the Diagnosis of Suspected Acute Appendicitis.

Document Type : Original Article

Authors

1 Department of General Surgery, Faculty of Medicine, Cairo University, Egypt

2 Department of Radiology, Faculty of Medicine, Cairo University, Egypt

Abstract

Background: One of the most frequent reasons for acute abdomen that necessitates surgery is acute appendicitis.
Even though appendicectomy is the standard treatment, there is a chance of complications following surgery. To assess
individuals exhibiting equivocal symptoms, computed tomography (CT) scans have been introduced. Its application
might reduce needless intervention by stratifying patients.
Objectives: To evaluate the diagnostic precision of contrast-enhanced computed tomography for suspected acute
appendicitis.
Methods: Seventy-three individuals with probable acute appendicitis (Alvarado score range from 4 to 6) were included in
this research. Prior to appendectomy, the patients had preoperative CT scans of their abdomen and pelvis with intravenous contrast. The final pathology was correlated with the CT results.
Results: The mean age of the study population 26.7 ± SD 11.9 years old. The incidence of positive appendicitis by
intraoperative assessment was 70.5% while the incidence was 79.5 % by definitive pathological diagnosis. CT scan in the
preoperative settings had a sensitivity, specificity and diagnostic accuracy of 75.3%, 100% and 80.3% respectively. There
were 5 significant CT predictors for acute appendicitis: Distended appendix, thick enhancing wall, fat plane smudging,
periappendicular fluid collection and appendicolith. A CT scoring system was created using the significant findings. A
score of 2 or more had a 70.5% sensitivity, 100% specificty for diagnosing a pathologically proven acute appendicitis.
Conclusion: CT abdomen and pelvis with IV contrast is a useful tool with high accuracy in diagnosing or excluding acute
appendicitis.

Keywords

The Egyptian Journal of Surgery
Volume 44, Issue 2
April 2025
Pages 708-717

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