Routine Computed Tomography Versus Selective Imaging: An Audit of Negative Appendicectomy Rates in Two Hospitals.
appendectomy
appendicitis
computer tomography
imaging
negative appendectomy rate
ultrasonography
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
accepted:
10
12
2022
entrez:
12
1
2023
pubmed:
13
1
2023
medline:
13
1
2023
Statut:
epublish
Résumé
Introduction There are a variety of conflicting recommendations in the literature for pre-operative imaging in acute appendicitis. There is debate over what the ideal imaging protocol is to lower the negative appendicectomy rate (NAR) without increasing missed appendicitis. The aim of this study is to compare the audited NAR between two groups with different imaging approaches: (i) mandatory pre-operative computed tomography (CT) imaging and (ii) selective imaging with CT, ultrasound (US), or no imaging prior to appendicectomy. Materials and methods A retrospective chart audit was conducted of 400 patients who underwent an appendicectomy at two hospitals with different approaches to pre-operative imaging (hospital A and hospital B). The primary outcome measure was histologically confirmed appendicitis. It was also documented whether there was radiological (CT or US) evidence of appendicitis. Results At hospital A, all 200 patients underwent CT imaging prior to appendicectomy. The total histologically confirmed NAR for this group was 9.5% (19/200). At hospital B, 97 (48.5%) patients underwent CT, 41 (25.5%) underwent US, 10 (5%) had both US and CT, and 52 (26%) had no imaging. The total NAR was 11.5% (23/200). Conclusion There was no statistically significant difference (p=0.62) in audited NARs when comparing clinician-guided selective imaging versus routine CT imaging for all patients undergoing appendicectomy.
Identifiants
pubmed: 36632248
doi: 10.7759/cureus.32389
pmc: PMC9830005
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e32389Informations de copyright
Copyright © 2022, Symonds et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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