title: Clinical factors influencing CT findings in patients with acute appendicitis.
abstract: OBJECTIVE
  CT has proven useful in diagnosing appendicitis, but it also has some disadvantages. In this study we investigated clinical factors influencing CT findings of acute appendicitis and identified the most appropriate patients for preoperative CT.
  
  
  METHODS
  Enhanced helical CT scans were obtained preoperatively in 95 patients who underwent appendectomy. They were gangrenous in 52 (55%), phlegmonous in 38 (40%) and catarrhal in 5 (5%) and we usually indicated emergent surgery for phlegmonous or gangrenous appendicitis patients. 62 (69%) of 90 phlegmonous or gangrenous cases had both an enlarged appendix (> or = 6mm) and periappendiceal fat strand in CT, which strongly suggested the need for emergent operation (Positive group). We compared clinical factors in the positive group with those in the other 28 patients (Equivocal group).
  
  
  RESULTS
  There was no significant difference between the positive and equivocal groups in age, gender, or white blood cell count. The depth of subcutaneous fat (SCF) at the umbilicus level in CT and the number of patients with gangrenous appendicitis were significantly increased in the positive group compared with the equivocal group by both univariate and multilogistic regression analysis.
  
  
  CONCLUSIONS
  These indicated that the degree of inflammation and SCF were significantly associated with CT findings of appendicitis and CT should be routinely done in obese patients.
authors.affiliation: Department of first Surgery, Gunma University School of Medicine, Japan. katukada@topaz.ocn.ne.jp
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Tsukada
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Katoh
authors.forename: Norihiro
authors.initials: N
authors.lastname: Masuda
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ojima
authors.forename: Minoru
authors.initials: M
authors.lastname: Fukuchi
authors.forename: Rokuhei
authors.initials: R
authors.lastname: Manda
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Fukai
authors.forename: Masanobu
authors.initials: M
authors.lastname: Nakajima
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Ishizaki
authors.forename: Masahiko
authors.initials: M
authors.lastname: Motegi
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Ohsawa
authors.forename: Akira
authors.initials: A
authors.lastname: Mogi
authors.forename: Akihiko
authors.initials: A
authors.lastname: Okamura
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Tsunoda
authors.forename: Makoto
authors.initials: M
authors.lastname: Sohda
authors.forename: Tetsuroh
authors.initials: T
authors.lastname: Ohno
authors.forename: Takao
authors.initials: T
authors.lastname: Moteki
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Sekine
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D000208:Acute Disease; D000328:Adult; D000704:Analysis of Variance; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000175:diagnosis* / Q000601:surgery*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D036542:Tomography, Spiral Computed / Q000379:methods*; D016896:Treatment Outcome