Mustafa Hasbahçeci1, Cengiz Erol2, Mustafa Törü3, Mehmet Şeker4. 1. Department of General Surgery, Faculty of Medicine, Bezmialem Vakıf University, İstanbul, Turkey. 2. Department of Radiology, Faculty of Medicine, İstanbul Medipol University, İstanbul, Turkey. 3. Department of Radiology,29 May Hospital, Ankara, Turkey. 4. Department of Radiology, 29 May Hospital, İstanbul, Turkey.
Abstract
OBJECTIVE: The accuracy of a surgeon's judgement still remains to be controversial in the diagnosis of acute appendicitis, which is a diagnosis usually based on laboratory data and imaging tests. MATERIAL AND METHODS: Patients with a possible diagnosis of acute appendicitis were reviewed retrospectively with regard to demographic variables, laboratory and imaging results, and treatment modalities. RESULTS: There were 128 patients with a mean age of 31.2±14 years. The mean white blood cell count and the proportion of polymorphonuclear leukocytes were 11403±4669/mm(3) and 75±11%, respectively. Appendectomy was performed on 66 (51.6%) patients. Conservative management was applied to 62 (48.4%) patients. Statistical analysis showed that patients with appendicitis have a higher white blood cell count (p=0.015) and a higher proportion of polymorphonuclear leukocytes (p=0.023). Sensitivity, specificity and accuracy rates were 84.6%, 63.7% and 74.3% for ultrasound and 100%, 86.7% and 92.2% for computed tomography, respectively. CONCLUSION: Diagnosis based on patients' laboratory and imaging data, in combination with, the surgeon's judgement appears to yield the best outcomes in patients with suspicion of acute appendicitis.
OBJECTIVE: The accuracy of a surgeon's judgement still remains to be controversial in the diagnosis of acute appendicitis, which is a diagnosis usually based on laboratory data and imaging tests. MATERIAL AND METHODS:Patients with a possible diagnosis of acute appendicitis were reviewed retrospectively with regard to demographic variables, laboratory and imaging results, and treatment modalities. RESULTS: There were 128 patients with a mean age of 31.2±14 years. The mean white blood cell count and the proportion of polymorphonuclear leukocytes were 11403±4669/mm(3) and 75±11%, respectively. Appendectomy was performed on 66 (51.6%) patients. Conservative management was applied to 62 (48.4%) patients. Statistical analysis showed that patients with appendicitis have a higher white blood cell count (p=0.015) and a higher proportion of polymorphonuclear leukocytes (p=0.023). Sensitivity, specificity and accuracy rates were 84.6%, 63.7% and 74.3% for ultrasound and 100%, 86.7% and 92.2% for computed tomography, respectively. CONCLUSION: Diagnosis based on patients' laboratory and imaging data, in combination with, the surgeon's judgement appears to yield the best outcomes in patients with suspicion of acute appendicitis.
Authors: John M Howell; Orin L Eddy; Thomas W Lukens; Molly E W Thiessen; Scott D Weingart; Wyatt W Decker Journal: Ann Emerg Med Date: 2010-01 Impact factor: 5.721
Authors: Pierre-Alexandre Poletti; Alexandra Platon; Thomas De Perrot; Francois Sarasin; Elisabeth Andereggen; Olivier Rutschmann; Elise Dupuis-Lozeron; Thomas Perneger; Pascal Gervaz; Christoph D Becker Journal: Eur Radiol Date: 2011-07-30 Impact factor: 5.315
Authors: Naresh Ramarajan; Rajesh Krishnamoorthi; Richard Barth; Pejman Ghanouni; Claudia Mueller; Bernard Dannenburg; N Ewen Wang Journal: Acad Emerg Med Date: 2009-11 Impact factor: 3.451
Authors: A van Randen; W Laméris; H W van Es; W ten Hove; W H Bouma; M S van Leeuwen; E M van Keulen; V P M van der Hulst; O D Henneman; P M Bossuyt; M A Boermeester; J Stoker Journal: Eur Radiol Date: 2010-01-30 Impact factor: 5.315
Authors: Pieter Poortman; Henk J M Oostvogel; Eelke Bosma; Paul N M Lohle; Miguel A Cuesta; Elly S M de Lange-de Klerk; Jaap F Hamming Journal: J Am Coll Surg Date: 2009-03 Impact factor: 6.113
Authors: Boudewijn R Toorenvliet; Fraukje Wiersma; Rutger F R Bakker; Jos W S Merkus; Paul J Breslau; Jaap F Hamming Journal: World J Surg Date: 2010-10 Impact factor: 3.352