CT is useful for identifying patients with complicated appendicitis.
OBJECTIVE
We often come across patients with complicated appendicitis (perforation, abscess formation, or peritonitis) and it is essential to get accurate and detailed information on these patients preoperatively. In this study, we investigated whether or not preoperative computed tomography is useful for identifying these patients.


METHODS
Plain and intravenously-contrasted helical computed tomography was obtained preoperatively in 94 (75%) of 125 patients who underwent appendectomy. Twenty-eight (30%) of the 94 patients had complicated appendicitis (Compli(+) group). We compared clinical factors and computed tomography findings of the Compli(+) group with those of 66 other patients (Compli(-) group).


RESULTS
There was no significant difference between the Compli(+) and Compli(-) groups in gender, white blood cell count, the present rate of an enlarged appendix, or appendicolith. Fat stranding and free fluid on computed tomography were significantly associated with complicated appendicitis by both univariate and multilogistic regression analysis. Fourteen (70%) of the 20 patients with fat stranding and free fluid on computed tomography had complicated appendicitis and only 1 (4%) of the 28 Compli(+) patients had neither fat stranding nor free fluid on computed tomography.


CONCLUSIONS
Our study has indicated that fat stranding and free fluid on computed tomography are significant for complicated appendicitis and helical computed tomography is a powerful tool for identifying patients with complicated appendicitis preoperatively.
Tsukada
K
K
Department of First Surgery, Gunma University School of Medicine, 3-39-22 Showamachi, Maebashi 371-8511, Japan. katukada@topaz.ocn.ne.jp
Miyazaki
T
T
Katoh
H
H
Masuda
N
N
Ojima
H
H
Fukuchi
M
M
Manda
R
R
Fukai
Y
Y
Nakajima
M
M
Ishizaki
M
M
Motegi
M
M
Ohsawa
H
H
Mogi
A
A
Okamura
A
A
Tsunoda
Y
Y
Sohda
M
M
Ohno
T
T
Moteki
T
T
Sekine
T
T
Kuwano
H
H
D000328:Adult; D001064:Appendicitis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D001065:Appendix / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed; D014057:Tomography, X-Ray Computed