The usefulness and positive predictive value of ultrasonography and computed tomography in the diagnosis of acute appendicitis in adults: a retrospective study

M A Depetris; E Martínez Chamorro; L Ibáñez Sanz; J C Albillos Merino; E Rodríguez Cuellar; S Borruel Nacenta

doi:10.1016/j.rx.2020.10.007

The usefulness and positive predictive value of ultrasonography and computed tomography in the diagnosis of acute appendicitis in adults: a retrospective study

Radiologia (Engl Ed). 2020 Dec 14:S0033-8338(20)30161-2. doi: 10.1016/j.rx.2020.10.007. Online ahead of print.

[Article in English, Spanish]

Authors

M A Depetris¹, E Martínez Chamorro¹, L Ibáñez Sanz¹, J C Albillos Merino¹, E Rodríguez Cuellar², S Borruel Nacenta³

Affiliations

¹ Servicio de Radiodiagnóstico, Hospital Universitario 12 de Octubre, Madrid, España.
² Servicio de Cirugía General, Hospital Universitario 12 de Octubre, Madrid, España.
³ Servicio de Radiodiagnóstico, Hospital Universitario 12 de Octubre, Madrid, España. Electronic address: sborruel.hdoc@salud.madrid.org.

PMID: 33334589
DOI: 10.1016/j.rx.2020.10.007

Abstract

Objective: To analyze the evolution of the use of imaging tests (ultrasonography and computed tomography (CT)) in the diagnosis of acute appendicitis. To determine the positive predictive value of these tests and the percentage of negative and complicated appendectomies.

Material and methods: This retrospective study compared adults who underwent appendectomy for suspected acute appendicitis at our tertiary hospital during 2015 versus similar patients at our center during 2007.

Results: A total of 278 patients were included. The rate of negative appendectomies descended to 5%. The positive predictive value of ultrasonography increased to 97.4% in 2015, and the positive predictive value of CT and combined CT and ultrasonography was 100%. The rate of complicated appendicitis increased (23% in 2015).

Conclusions: The use of imaging tests increased, and the rate of "blind" laparotomies decreased. Nevertheless, the rate of complicated appendicitis increased.

Keywords: Acute appendicitis; Apendicectomías negativas; Apendicitis aguda; Apendicitis gangrenosa; Apendicitis perforada; Computed tomography; Ecografía; Gangrenous appendicitis; Negative appendectomy; Perforated appendicitis; TC; Ultrasonography.