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). 2022 Nov-Dec;64(6):506-515. doi: 10.1016/j.rxeng.2020.10.009. Epub 2022 Jun 2.

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 278patients 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.

MeSH terms

  • Acute Disease
  • Adult
  • Appendicitis* / diagnostic imaging
  • Appendicitis* / surgery
  • Humans
  • Predictive Value of Tests
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods
  • Ultrasonography