CT screening reduces need for appendectomy
19 June 2005
A study of appendectomy patients at Massachusetts General Hospital (MGH)
in Boston, USA has shown that, since the advent of CT screening five years
ago, the negative appendectomy rate has dropped from 20% to 3%.
The negative appendectomy rate measures how often patients with symptoms
of appendicitis have their appendix removed and then are diagnosed as not
having acute appendicitis.
For the study, the researchers analyzed 663 patients who were examined on
CT for suspected appendicitis. An appendectomy was performed on 268 of the
CT-screened patients. Of these 268 patients, only 8 (3%) had a negative
“Prior to CT the negative appendectomy rate was 20% because there was no
way to be sure whether appendicitis was present or not in most patients
without surgery. Because CT is very accurate in imaging the appendix and
because CT is very good at finding other conditions which mimic
appendicitis, the negative appendectomy rate following CT has fallen
dramatically. Fewer people are having to undergo appendectomy because CT can
find the normal appendix and can frequently determine what is wrong prior to
surgery,” said James T. Rhea, MD, lead author of the study at MGH and who is
now at San Francisco General Hospital in California.
According to the study, if a patient is suspected of having appendicitis,
CT can help diagnose before surgery whether appendicitis is present or
whether something else other than appendicitis is causing the patient’s
pain. “The patient’s doctor should decide if CT is needed to increase the
certainty that appendicitis is present or if something else is causing the
problem, but in most patients CT will be helpful in deciding whether to
remove the appendix. I know that if I had symptoms that might be
appendicitis, I’d want to have a CT scan,” said Dr. Rhea.
The study appears in the June 2005 issue of the American Journal of
Roentgenology. AJR Jun 2005;184:1802-1808
Source: American Roentgen Ray Society (ARRS)