Less negative appendectomies due to imaging in patients with suspected appendicitis
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.
KeywordsAppendicitis Imaging Guideline
P. A. Boonstra, R. N. van Veen, H. B. A. C. Stockmann have no conflict of interest.
- 4.Bakker OJ, Go PMNYH, Puylaert JBCM et al (2010) Richtlijn voor diagnostiek en behandeling van acute appendicitis. Nederlands Tijdschrift voor de Geneeskunde 154:A303Google Scholar
- 21.Kathouda N, Mason RJ, Towfigh S (2005) Laparoscopic versus open appendectomy, a prospective randomized double-blind study. Ann Surg 242(3):439–448Google Scholar
- 26.Poortman P, Lohle P, Schoemaker C et al (2003) Comparison of CT and sonography in the diagnosis of acute appendicitis: a blinded prospective study. Am J Radiol 181:1355–1359Google Scholar