Saad Jamal, Ameet Jesrani, Rizwan Ajmal, Kashif Shazlee, Jaideep Darira, Rehan Alamgir.
Impact of ct-fact on negative appendectomy rates: prospective evaluation from a tertiary care hospital.
Pak J Radiol Jan ;29(4):239-44.

ABSTRACT Objective: To determine and compare the frequency of negative appendectomy in cases of acute appendicitis with and without pre-op computed. Design: Experimental study (Clinical trial) Patients and Methods: A total of 116 patients, presenting to the emergency department, Ziauddin University Hospital, Karachi, with acute abdominal pain were assessed using Alvarado scoring system for the clinical diagnosis of acute appendicitis by primary attending surgeon. All patients fulfilling the inclusion criteria and diagnosed as acute appendicitis on clinical grounds through Alvarado score of 7 or more, were offered pre-op CT scan and informed consent was sought. Those patients who was agree and give consent for pre-op CT scan will placed in group A while those who were not give consent for pre-op CT scan were placed in group B. Patients in group A were subjected to computed tomography (CT scan) for the radiological diagnosis of acute appendicitis based on operational definitions, before going for appendectomy, whereas group B patients were proceed to appendectomy directly. After performing appendicectomy, the resected sample was then sent for histopathological examination to the same laboratory and examination conducted by an experienced pathologist. Data was entered on a predesigned proforma. Results: The negative appendectomy rate was 6.9% in 4 patients with pre appendectomy CT and 19% in 11 patients without pre appendectomy CT (P- value 0.04). Conclusion: The results show that CT in patients with suspected appendicitis leads to lower negative appendectomy rates. Therefore, we propose that preoperative imaging be considered part of the routine evaluation of women suspected of having acute appendicitis.

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