The value of limited computed tomography with rectal contrast in the diagnosis of acute appendicitis.
BACKGROUND
Multiple nonrandomized studies demonstrate the accuracy of computed tomography (CT) scan in diagnosing appendicitis. This study compared CT scan with standard management in diagnosing appendicitis.


METHODS
This was a prospective randomized study of patients who received general surgery consultation for appendicitis. Patients were randomized to receive CT scan or standard management.


RESULTS
There were 65 patients in the CT scan group and 63 patients in the standard management group. The sensitivity, specificity, and accuracy of CT scan were 94%, 100%, and 96%, respectively. CT scan positively altered the management in 26% and made alternative diagnoses in 14%. The sensitivity, specificity, and accuracy of the standard management group were 100%, 79%, and 89%, respectively. The standard management group had a negative appendectomy rate of 19%.


CONCLUSIONS
CT scan with rectal contrast is an effective method for diagnosing appendicitis and should be performed in all patients suspected of having appendicitis.
Walker
S
S
Department of Surgery Education, Exempla Saint Joseph Hospital, Denver, Colorado, USA.
Haun
W
W
Clark
J
J
McMillin
K
K
Zeren
F
F
Gilliland
T
T
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001064:Appendicitis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012007:Rectum / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods