title: Less negative appendectomies due to imaging in patients with suspected appendicitis.
abstract: BACKGROUND
  The optimal diagnostics and treatment of acute appendicitis continues to be a challenge. We evaluated the implementation of the guideline "diagnostics and treatment in acute appendicitis" in 2010. This guideline states that, in every patient with clinically suspected acute appendicitis, an ultrasonography or CT scan is advised to confirm the diagnosis before surgery.
  
  
  METHODS
  We selected all consecutive patients with acute appendicitis in our hospital in the years 2008 and 2011. We compared the use of imaging and the operation results in both years.
  
  
  RESULTS
  In 2008, 228 patients were treated for acute appendicitis. In 43 %, imaging was performed. In 2011, 238 patients were treated; in 99 % of the cases, imaging was performed. A decrease in patients with negative appendectomy was seen from 19 % in 2008 to 5 % in 2011. Financial analysis showed a reduction in costs favoring 2011.
  
  
  CONCLUSIONS
  The increased use of pre-operative imaging in patients with suspected acute appendicitis resulted in a cost-effective way to decrease the number of patients with negative appendectomies.
authors.affiliation: Department of Surgery, Kennemer Gasthuis, Boerhaavelaan 22, 2035 RC, Haarlem, The Netherlands, pieter.boonstra@gmail.com.
authors.forename: P A
authors.initials: PA
authors.lastname: Boonstra
authors.forename: R N
authors.initials: RN
authors.lastname: van Veen
authors.forename: H B A C
authors.initials: HB
authors.lastname: Stockmann
mesh_terms: D000208:Acute Disease; D000328:Adult; D001062:Appendectomy; D001064:Appendicitis / Q000000981:diagnostic imaging* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*