title: Does selective use of computed tomography scan reduce the rate of "white" (negative) appendectomy?
abstract: BACKGROUND
  Appendectomies are the most common operations performed on an emergency basis. The accepted rate of "white" appendectomies is around 20%. In recent years, computed tomography (CT) scanning has been recognized as a valuable tool with high sensitivity and specificity in the diagnosis of acute appendicitis. The use of CT scans in the management of patients with suspected acute appendicitis is increasing worldwide.
  
  
  OBJECTIVE
  To assess whether introducing more liberal use of CT in the management of patients presenting to the emergency room with right lower quadrant pain or suspected acute appendicitis would reduce the rate of "white" appendectomies.
  
  
  METHODS
  We conducted a retrospective study of the pathology reports and CT scans of all patients who underwent appendectomy during a 3 year period. We examined the correlation between the rate of CT scans performed and the rate of "white" appendectomies.
  
  
  RESULTS
  Overall, we performed 797 appendectomies during the study period. In 2004, we performed 272 appendectomies and CT in 34 patients (12.5%). In 2005, we performed 275 appendectomies and CT in 83 patients (30.2%). In 2006, we performed 250 appendectomies and CT in 88 patients (35.2%). The percentage of "white" appendectomies decreased from 29% in 2004 to 21.1% in 2005 and to 18.8% in 2006.
  
  
  CONCLUSIONS
  It appears that a more selective use of CT scans in the management of suspected appendicitis could reduce the rate of "white" appendectomies.
authors: Itay
authors: I
authors: Zoarets
authors: Natan
authors: N
authors: Poluksht
authors: Ariel
authors: A
authors: Halevy
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D001062:Appendectomy / Q000706:statistics & numerical data*; D001064:Appendicitis / Q000175:diagnosis* / Q000601:surgery; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*