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| Topic: |
Digestive Diseases (DD) |
| Title: |
Appendicitis: Should Diagnostic Imaging Be Performed if the Clinical Presentation is Highly Suggestive of the Disease?. |
| Author: |
Rettenbacher, T., et al. |
| Source: |
Gastroenterology. 123(4): 992-998. October 2002. |
| Availability: |
Available from W.B. Saunders Company. 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Website: www.gastrojournal.org. |
| Abstract: |
This article reports on a study that investigated whether diagnostic imaging is required if the clinical presentation suggests acute appendicitis with high probability. On the basis of clinical findings, 350 consecutive patients with clinical suspicion of acute appendicitis were prospectively divided into 3 groups as follows: low, intermediate, and high probability of having appendicitis. All patients then underwent diagnostic ultrasonography. The clinical likelihood of appendicitis and the ultrasonography results were correlated with the definite diagnoses. In the patients with clinically low probability of having appendicitis, appendicitis was present in 10 percent (11 of 109 patients), and, in those with intermediate probability, appendicitis was present in 24 percent (23 of 97 patients). Patients with clinically high probability of having appendicitis had appendicitis in 65 percent (94 of 144 patients), an alternative diagnosis in 18 percent (26 of 144 patients), and no specific definitive diagnosis in 17 percent (24 of 144 patients). The authors conclude that even in patients with clinically high probability of acute appendicitis, diagnostic imaging should be performed because it accurately depicts a high percentage of normal appendices and differential diagnoses. 1 figure. 5 tables. 37 references. |
| Format: |
Journal Article |
| Language: |
English. |
| Major Keywords: |
Digestive System Diseases. Appendicitis. Diagnostic Tests. Patient Selection. Test Reliability. Symptoms. Physical Examination. |
| Minor Keywords: |
Diagnosis. Patient Care Management. Abdominal Pain. Ultrasound. |
| Publication Number: |
DDJA09358 |
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