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World Journal of Surgery

, Volume 36, Issue 7, pp 1546–1547 | Cite as

Evaluation of the Appendicitis Inflammatory Response Score for Patients with Acute Appendicitis

  • Roland E. AnderssonEmail author
Invited Commentary

The role of clinical diagnosis and diagnostic techniques in the management of patients with suspicion of acute appendicitis (AA) is controversial. Clinical diagnosis with repeat examination after observation in unclear cases is regarded as unreliable, impractical, and outdated. Diagnostic imaging with routine computed tomography (CT) scan or a combination of ultrasound (US) examination and selective CT scan in unclear cases is often proposed as the ultimate solution. This antagonism between clinical diagnosis and imaging is, however, based on misunderstanding and simplification. We need all diagnostic techniques in the arsenal, but we need to better define the role for each of them.

All algorithms for the management of patients with AA start with the selection of patients with suspected AA at the primary evaluation. Not all patients with abdominal pain can or should have diagnostic imaging, and if they had, then the results would be suboptimal because of a high rate of false-positive...

Keywords

Appendicitis Diagnostic Imaging Acute Appendicitis Perforated Appendicitis Suspected Appendicitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Terasawa T, Blackmore CC, Bent S, Kohlwes RJ (2004) Systematic review: computed tomography and ultrasonography to detect acute appendicitis in adults and adolescents. Ann Intern Med 141:537–546PubMedGoogle Scholar
  2. 2.
    Brenner DJ, Hall EJ (2007) Computed tomography—an increasing source of radiation exposure. N Engl J Med 357:2277–2284PubMedCrossRefGoogle Scholar
  3. 3.
    Andersson RE, Hugander AP, Ghazi SH, Ravn H, Offenbartl SK, Nystrom PO, Olaison GP (2000) Why does the clinical diagnosis fail in suspected appendicitis? Eur J Surg 166:796–802PubMedCrossRefGoogle Scholar
  4. 4.
    de Castro S, Unlü C, Steller EP et al (2012) Evaluation of the appendicitis inflammatory response score for patients with acute appendicitis. World J Surg 36. doi: 10.1007/s00268-012-1521-4
  5. 5.
    Toorenvliet BR, Wiersma F, Bakker RF, Merkus JW, Breslau PJ, Hamming JF (2010) Routine ultrasound and limited computed tomography for the diagnosis of acute appendicitis. World J Surg 34:2278–2285. doi: 10.1007/s00268-010-0694-y PubMedCrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  1. 1.Department of SurgeryCounty Hospital RyhovJönköpingSweden
  2. 2.Department of Clinical and Experimental MedicineUniversity HospitalLinköpingSweden

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