title: Impact of adjunctive testing on the diagnosis and clinical course of patients with acute appendicitis.
abstract: The diagnosis of acute appendicitis is usually made from the history and physical examination. Recently, abdominal ultrasonography (US), laparoscopy, computerized tomography (CT), and barium enema (BE) have been used in the preoperative evaluation of patients with presumed appendicitis in order to improve the diagnostic accuracy. However, the usefulness of these tests in verifying the diagnosis of appendicitis has not been established. We reviewed the medical records of 203 patients who underwent appendectomy. One hundred patients were surgically treated before 1984 (group I) and 103 patients underwent surgery after 1988 (group II). Patients in group II were more likely to have preoperative US, laparoscopy, CT, or BE (24 in group II versus 3 in group I, p < 0.05). When groups I and II were compared, the rates of perforation (27% versus 20%), normal appendectomy (8% versus 11%), and the interval between admission and operation (12.2 hours versus 10.7 hours) and length of hospitalization (5.0 days versus 5.1 days) were not significantly different. We concluded that although adjunctive testing may be beneficial in selected patients, its routine use in patients suspected of having appendicitis cannot be advocated at present.
authors.affiliation: Department of Surgery, University of Arizona Health Sciences Center, Tucson 85724.
authors.forename: M R
authors.initials: MR
authors.lastname: Sarfati
authors.forename: G C
authors.initials: GC
authors.lastname: Hunter
authors.forename: D B
authors.initials: DB
authors.lastname: Witzke
authors.forename: G G
authors.initials: GG
authors.lastname: Bebb
authors.forename: S H
authors.initials: SH
authors.lastname: Smythe
authors.forename: S
authors.initials: S
authors.lastname: Boyan
authors.forename: W D
authors.initials: WD
authors.lastname: Rappaport
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001062:Appendectomy; D001064:Appendicitis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D001466:Barium Sulfate; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D001466:Barium Sulfate