Clinical guidelines, computed tomography scan, and negative appendectomies: a case series.
BACKGROUND
Prior studies suggest that preoperative abdominal computed tomography (CT) scan can contribute to a low negative appendectomy rate. Our study objective was to evaluate cases of negative appendectomies for clinical criteria and CT use.


METHODS
Retrospective 1-year study of all negative appendectomies at a community hospital. Data included clinical evidence for appendicitis as well as CT results if performed.


RESULTS
Of 122 cases reviewed, 8 (6.6%) were negative appendectomies. Six were younger than 20 years. Four had a preoperative CT scan. Overall, 106 (87%) of 122 cases received preoperative CT and had a negative appendectomy rate of 3.8%. Sixteen cases did not have preoperative CT and had a negative appendectomy rate of 25% (odds ratio, 8.5; 95% confidence interval, 1.9-38.5; Fisher exact test P = .01).


CONCLUSIONS
Patients who had a CT scan for suspected appendicitis had a lower rate of negative appendectomies than those who had no CT. Most of the negative appendectomies occurred in patients younger than 20 years.
Harswick
Chad
C
Resurrection Emergency Medicine Residency Program, Resurrection Medical Center, Chicago, IL 60631, USA.
Uyenishi
Amy Archer
AA
Kordick
Mary Frances
MF
Chan
Shu B
SB
D015746:Abdominal Pain / Q000209:etiology; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000855:Anorexia / Q000209:etiology; D001062:Appendectomy; D001064:Appendicitis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed