Surgical Endoscopy

, Volume 29, Issue 8, pp 2365–2370 | Cite as

Less negative appendectomies due to imaging in patients with suspected appendicitis

  • P. A. BoonstraEmail author
  • R. N. van Veen
  • H. B. A. C. Stockmann



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.

Patients and 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.


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.


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.


Appendicitis Imaging Guideline 



P. A. Boonstra, R. N. van Veen, H. B. A. C. Stockmann have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • P. A. Boonstra
    • 1
    Email author
  • R. N. van Veen
    • 1
  • H. B. A. C. Stockmann
    • 1
  1. 1.Department of SurgeryKennemer GasthuisHaarlemThe Netherlands

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