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Utility of Abdominal Computerized Tomography in Diagnosis of Acute Appendicitis

Korean Journal of Pediatrics 2004;47(3):290-293.
Published online March 15, 2004.
Utility of Abdominal Computerized Tomography in Diagnosis of Acute Appendicitis
Su Jin Sung1, Ji Young Yeoun2, Seong Hoon Lee2
1Department of Pediatrics, Chonnam Hospital, Yeosu, Korea
2Department of Surgery, Chonnam Hospital, Yeosu, Korea
급성 충수염의 진단에 있어 복부 전산화 단층촬영의 유용성
성수진1, 윤지영2, 이승훈2
1여수 전남병원 소아과
2여수 전남병원 일반외과
Correspondence: 
Su Jin Sung, Email: sujin282001@yahoo.com
Abstract
Purpose
: To evaluate the accuracy of ultrasonography(USG) and abdominal computerized tomography(CT) and the possibility of reducing unnecessary appendectomy rate with improvement of diagnostic accuracy using optional CT with USG.
Methods
: From January 1999 to May 2003, 496 patients younger than 14 years received surgical intervention with preoperative impression of acute appendicitis. They were devided into three groups no preoperative imaging study; preoperative abdominal USG only; and USG with optional abdominal CT. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated in each group, and percentage of unnecessary appendectomy was also obtained.
Results
: Sensitivity and unnecessary appendectomy rate of group was 78.4% and 21% respectively. Sensitivity, specificity, positive predictive value, negative predictive value and unnecessary appendectomy rates of group were 96.5%, 42.8%, 85.4%, 78% and 12.2%. Sensitivity and positive predictive value of group was 100% and 98%, and no unnecessary appendectomy was performed in this group.
Conclusion
: With consideration of radiation exposure, cost, and in-hospital delay time, using optional CT with USG under optimal indication can decrease the frequency of complications and unnecessary appendectomy rates.
Key Words: Unnecessary appendectomy, Computed tomography, Ultrasonography, Appendicitis, Accuracy, Diagnostic errors


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