Appendicitis CT: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
m (Bot: Removing from Primary care)
 
(2 intermediate revisions by one other user not shown)
Line 4: Line 4:


==Overview==
==Overview==
[[CT scan]]s are the diagnostic test of choice for detecting [[appendicitis]]. As many as 45 percent of patients do not display classic signs of acute appendicitis, making imaging a potentially useful tool. They can provide critical information regarding the size of the [[appendix]]. CT scans are preferred over [[ultrasound]]s for the detection of appendicitis.
[[CT scan]]s are the diagnostic test of choice for detecting [[appendicitis]]. Findings on CT scan suggestive of appendicitis include appendicial wall thickening along with peri-appendiceal inflammation.


==CT==
==CT==
*To balance the risks of negative appendectomies, delayed surgery, or perforated appendices, physicians are increasingly ordering CT scans.<ref name="app1">Pender,N. CT Scans in the Diagnosis of Appendicitis.''Virtual Mentor''.2006; 8 (3): 154-156.</ref>
CT scan may be helpful in the diagnosis of appendicitis. A properly performed [[CT scan]] with modern equipment has a detection rate of over 95%. Findings on CT scan suggestive of appendicitis include:<ref name="wiki1">Appendicitis. Wikipedia (26 November 2015).https://en.wikipedia.org/wiki/Appendicitis#Imaging  Accessed on December 7, 2015</ref>
*In places where it is readily available, a [[CT scan]] has become the diagnostic test of choice for detecting [[appendicitis]], especially in adults whose diagnosis is not obvious on history and physical examination.
*Increase in appendiceal lumen with the outer-wall-to-outer-wall transverse diameter greater than 6 mm.<ref name="pmid19597855">{{cite journal |vauthors=Webb EM, Wang ZJ, Coakley FV, Poder L, Westphalen AC, Yeh BM |title=The equivocal appendix at CT: prevalence in a control population |journal=Emerg Radiol |volume=17 |issue=1 |pages=57–61 |year=2010 |pmid=19597855 |pmc=2773125 |doi=10.1007/s10140-009-0826-6 |url=}}</ref>
**Diagnosis of appendicitis by CT is made more difficult in very thin patients and in children, both of whom tend to lack significant fat within the abdomen.
*The accurate diagnosis of appendicitis is multi-tiered, with the size of the appendix having the strongest positive predictive value
*A properly performed [[CT scan]] with modern equipment has a detection rate of over 95%.<ref name="wiki1">Appendicitis. Wikipedia (26 November 2015).https://en.wikipedia.org/wiki/Appendicitis#Imaging  Accessed on December 7, 2015</ref>
 
===Use as a Diagnostic Tool===
*[[CT]] scans and [[ultrasound]] is more useful in the diagnosis of the disease when atypical symptoms are present. Surgical findings ([[suppuration]], [[abscess]], [[perforation]], etc.) are more apt to be severe in cases presenting with these symptoms.<ref name="wiki1">Appendicitis. Wikipedia (26 November 2015).https://en.wikipedia.org/wiki/Appendicitis#Imaging  Accessed on December 7, 2015</ref>
 
===Signs of Appendicitis on a CT Scan===
*Appendiceal thickening with the outer-wall-to-outer-wall transverse diameter greater than 6 mm.<ref name="pmid19597855">{{cite journal |vauthors=Webb EM, Wang ZJ, Coakley FV, Poder L, Westphalen AC, Yeh BM |title=The equivocal appendix at CT: prevalence in a control population |journal=Emerg Radiol |volume=17 |issue=1 |pages=57–61 |year=2010 |pmid=19597855 |pmc=2773125 |doi=10.1007/s10140-009-0826-6 |url=}}</ref>
*Appendiceal wall thickening (wall ≥ 3mm)<ref name="pmid14616200">{{cite journal |vauthors=Choi D, Park H, Lee YR, Kook SH, Kim SK, Kwag HJ, Chung EC |title=The most useful findings for diagnosing acute appendicitis on contrast-enhanced helical CT |journal=Acta Radiol |volume=44 |issue=6 |pages=574–82 |year=2003 |pmid=14616200 |doi= |url=}}</ref>
*Appendiceal wall thickening (wall ≥ 3mm)<ref name="pmid14616200">{{cite journal |vauthors=Choi D, Park H, Lee YR, Kook SH, Kim SK, Kwag HJ, Chung EC |title=The most useful findings for diagnosing acute appendicitis on contrast-enhanced helical CT |journal=Acta Radiol |volume=44 |issue=6 |pages=574–82 |year=2003 |pmid=14616200 |doi= |url=}}</ref>
**Appendiceal wall hyperenhancement
**Appendiceal wall hyperenhancement
**Mural stratification of the appendiceal wall
**Mural stratification of the appendiceal wall
**Appendicolith(s) (present in one third of patients with appendicitis).
*Periappendiceal inflammation includes:<ref name="pmid14616200" />
*Periappendiceal inflammation includes periappendiceal fat stranding, thickening of the lateral conal fascia, and mesoappendix, extraluminal fluid, phlegmon, abscess, ileocecal mild lymph node enlargement, and inflammatory thickening of contiguous structures.<ref name="pmid14616200">{{cite journal |vauthors=Choi D, Park H, Lee YR, Kook SH, Kim SK, Kwag HJ, Chung EC |title=The most useful findings for diagnosing acute appendicitis on contrast-enhanced helical CT |journal=Acta Radiol |volume=44 |issue=6 |pages=574–82 |year=2003 |pmid=14616200 |doi= |url=}}</ref>
**Periappendiceal fat stranding
 
**Thickening of the [[Fascia|lateral conal fascia]], and [[mesoappendix]]
Copyleft images obtained courtesy of Radswiki [http://radiopaedia.org/users/radswiki]
**Extraluminal fluid
 
**[[Phlegmon]]
'''Patient #1: Right lower quadrant pain'''
**[[Abscess]]
<gallery>
**[[Ileocecal]] mild [[Lymphadenopathy|lymph node enlargement]]
Image:
**[[Inflammatory]] thickening of contiguous structures
 
Appendicitis-001.jpg
 
Image:
 
Appendicitis-002.jpg
 
Image:
 
Appendicitis-003.jpg
 
Image:
 
Appendicitis-004.jpg
 
</gallery>
'''Patient #2: Right lower quadrant pain'''
<gallery>
Image:
 
App.jpg
 
Image:
 
App2.jpg
 
</gallery>
'''Patient #3: Right lower quadrant pain'''
<gallery>
Image:Appendicitis CT 105.jpg
 
Image:Appendicitis CT 106.jpg
 
Image:Appendicitis CT 107.jpg
 
Image:
 
Appendicitis CT 108.jpg
</gallery>


==References==
==References==
{{reflist|2}}
{{reflist|2}}
{{WH}}
{{WS}}


[[Category:Primary care]]
[[Category:Emergency medicine]]
[[Category:emergency medicine]]
[[Category:Inflammations]]
[[Category:Inflammations]]
[[Category:Medical emergencies]]
[[Category:Medical emergencies]]
Line 79: Line 32:
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Disease]]
[[Category:Disease]]
{{WH}}
{{WS}}

Latest revision as of 20:27, 29 July 2020

Appendicitis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Appendicitis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Diagnostic Scoring

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Appendicitis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Appendicitis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Appendicitis

CDC on Appendicitis

Appendicitis in the news

Blogs on Appendicitis

Directions to Hospitals Treating Appendicitis

Risk calculators and risk factors for Appendicitis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farwa Haideri [2]

Overview

CT scans are the diagnostic test of choice for detecting appendicitis. Findings on CT scan suggestive of appendicitis include appendicial wall thickening along with peri-appendiceal inflammation.

CT

CT scan may be helpful in the diagnosis of appendicitis. A properly performed CT scan with modern equipment has a detection rate of over 95%. Findings on CT scan suggestive of appendicitis include:[1]

References

  1. ↑ Appendicitis. Wikipedia (26 November 2015).https://en.wikipedia.org/wiki/Appendicitis#Imaging Accessed on December 7, 2015
  2. ↑ Webb EM, Wang ZJ, Coakley FV, Poder L, Westphalen AC, Yeh BM (2010). "The equivocal appendix at CT: prevalence in a control population". Emerg Radiol. 17 (1): 57–61. doi:10.1007/s10140-009-0826-6. PMC 2773125. PMID 19597855.
  3. ↑ 3.0 3.1 Choi D, Park H, Lee YR, Kook SH, Kim SK, Kwag HJ, Chung EC (2003). "The most useful findings for diagnosing acute appendicitis on contrast-enhanced helical CT". Acta Radiol. 44 (6): 574–82. PMID 14616200.

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Appendicitis_CT&oldid=1634791"