title: The clinical role of noncontrast helical computed tomography in the diagnosis of acute appendicitis.
abstract: BACKGROUND
  The accuracy of noncontrast helical computed tomography (CT) for appendicitis has recently been demonstrated. What is its clinical utility?
  
  
  METHODS
  This was a retrospective review of 443 consecutive community hospital patients evaluated for acute appendicitis over an 18-month period using limited pelvic CT scan or clinical acumen alone.
  
  
  RESULTS
  Appendicitis was pathologically proven in 158 patients. The negative appendectomy rate was 5.4%. The best radiological indicators for a positive CT for appendicitis were pericecal inflammation (88%) and appendicolith(57%). Appendiceal CT was found to have a 92% sensitivity, 99.6% specificity, and a 97.5% accuracy. There were 260 patients who had a negative CT; 243 of these were sent home. Alternative diagnoses were identified in 22% of patients.
  
  
  CONCLUSIONS
  The liberal use of noncontrast helical CT results in a low negative appendectomy rate and a high degree of confidence that a negative CT will allow patients to be sent home safely.
authors.affiliation: Departments of Surgery and Emergency Medicine, Tuality Community Hospital, Hillsboro, Oregon, USA.
authors.forename: J
authors.initials: J
authors.lastname: Peck
authors.forename: A
authors.initials: A
authors.lastname: Peck
authors.forename: C
authors.initials: C
authors.lastname: Peck
authors.forename: J
authors.initials: J
authors.lastname: Peck
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001064:Appendicitis / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*