Multidetector CT evaluation of alternative diagnosis of clinically suspected acute appendicitis, appendicular and nonappendicular lesions

Abstract

ObjectiveTo assess the accuracy of MDCT in diagnosis and preoperative evaluation of alternatives of acute appendicitis causing RLQP and associated complications. Patients and methods350 consecutive patients (250 males and 100 females) with ARLQP underwent MDCT examinations with contrast. Each scan was evaluated independently for the presence of inflammatory process (appendicitis), associated complications and for the detection of other findings rather than acute appendicitis causing RLQP. The radiological findings were compared with histopathological results for operated cases. Results146 typical cases out of 350 patients received CT diagnosis of acute appendicitis, 62 with complications such as appendicular abscess (n=32), appendicolith (n=7), mucocele (n=15), retrocecal appendix (n=5), and retroileal appendix (n=3); 63 patients received nonappendicular GIT causes, and 79 patients received alternative diagnosis of extra-GIT causes; patients who were operated upon based on either clinical diagnosis or US findings or both, with negative CT findings and pregnant women were excluded from the study. ConclusionMDCT can be used effectively in the preoperative evaluation of appendicitis, provides high accuracy for detecting complications, detects other findings causing RLQP, and better guides physicians for proper management of these patients.