Systematic Review: The Role of Intravenous and Oral Contrast in the Computed Tomography Evaluation of Acute Appendicitis

This systematic review provides practicing emergency physicians updated information regarding the role of oral and intravenous contrast in the computed tomography (CT) evaluation of acute appendicitis.
Source: The Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: AAEM Position Paper Source Type: research

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We report a case of appendiceal intussusception induced by a mucinous cystadenoma presenting as acute appendicitis. A 37-year-old woman was admitted with a one-day history of acute onset, right lower abdominal pain. Computed tomography showed swelling of the appendix, a pathological mass in the ileocolic region and oedematous pericolonic fat stranding. Emergency laparotomy via a McBurney incision revealed that the base of the appendix was swollen and intussuscepting into the caecum. Palpation of the caecum demonstrated an intraluminal mass, 6cm in size, at the appendicocaecal junction. After extension of the McBurney incis...
Source: Annals of the Royal College of Surgeons of England - Category: Surgery Authors: Tags: Ann R Coll Surg Engl Source Type: research
Objective: To compare diagnostic accuracy of contrast enhanced low-dose computed tomography (CT) accomplished in the OPTICAP trial phantom phase to standard CT in patients with suspected acute appendicitis. Background: Increasing use of CT as the gold standard in diagnosing acute appendicitis has raised concerns regarding radiation exposure. Unenhanced low-dose CT protocols have shown similar diagnostic accuracy with standard CT for diagnosing appendicitis. To our knowledge, there are no other trials in which the same patient with suspected acute appendicitis underwent both standard and low-dose CT allowing interpatie...
Source: Annals of Surgery - Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research
CONCLUSION: The strategy of repeating limited focused US followed by CT scan in cases that remain inconclusive has good diagnostic accuracy and reasonable NAR and decreases the number of CT scans. PMID: 31913249 [PubMed - as supplied by publisher]
Source: Pain Physician - Category: Anesthesiology Authors: Tags: Pediatr Emerg Care Source Type: research
Abstract OBJECTIVE: To survey care providers' willingness to use 2-mSv computed tomography (CT) in their usual practice for adolescents and young adults with suspected appendicitis. MATERIALS AND METHODS: An ethical committee approved this prospective study. We introduced 2-mSv CT in 20 hospitals through a pragmatic clinical trial. At the final phase of the trial, we invited 698 potentially-involved care providers in the survey regarding their willingness to use 2-mSv CT. Multivariable logistic regression analyses were performed to identify factors associated with willingness. Nine months after the completion...
Source: Korean J Radiol - Category: Radiology Authors: Tags: Korean J Radiol Source Type: research
ConclusionsAn abdominal wall abscess developed in association with the migration of an ingested fish bone. We suggest that a laparoscopic surgical resection of the portion of the bowel that includes the foreign body is a useful option for selected cases.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
No abstract available
Source: Medicine - Category: Internal Medicine Tags: Erratum Source Type: research
(Aust N Z J Obstet Gynaecol. 2019;59:45–53) The most common emergency nonobstetric abdominal surgery performed in parturients is appendicectomy, which occurs in ∼0.3% of pregnancies. Establishing the diagnosis of appendicitis is more challenging in pregnant women as a result of the physiological changes of pregnancy and the many non-specific symptoms experienced during normal pregnancy. In addition, the use of ultrasound to make the diagnosis is less effective due to the presence of the gravid uterus and computed tomography scanning is sometimes avoided to prevent fetal radiation exposure. Appendiceal perforatio...
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Epidemiologic Reports Surveys Source Type: research
Conclusion: Although PMP is a relatively rare entity, radiologists must be aware of its possible imaging findings, common locations, and possible patterns of recurrence. The origin of the primary tumor should also be investigated. Future studies are needed in order to determine which preoperative imaging findings predict surgical outcomes and to characterize the main findings of radiological recurrence.Resumo Objetivo: Determinar as caracter ísticas de imagem mais frequentes do pseudomixoma peritonial (PMP), bem como os subtipos histológicos dos tumores primários. Materiais e Métodos: Foram revi...
Source: Radiologia Brasileira - Category: Radiology Source Type: research
Conclusion: Although PMP is a relatively rare entity, radiologists must be aware of its possible imaging findings, common locations, and possible patterns of recurrence. The origin of the primary tumor should also be investigated. Future studies are needed in order to determine which preoperative imaging findings predict surgical outcomes and to characterize the main findings of radiological recurrence.Resumo Objetivo: Determinar as caracter ísticas de imagem mais frequentes do pseudomixoma peritonial (PMP), bem como os subtipos histológicos dos tumores primários. Materiais e Métodos: Foram revi...
Source: Radiologia Brasileira - Category: Radiology Source Type: research
CONCLUSIONS: The sensitivity and specificity of CT for diagnosing appendicitis in adults are high. Unenhanced standard-dose CT appears to have lower sensitivity than standard-dose CT with intravenous, rectal, or oral and intravenous contrast enhancement. Use of different types of contrast enhancement or no enhancement does not appear to affect specificity. Differences in sensitivity and specificity between low-dose and standard-dose CT appear to be negligible. The results of this review should be interpreted with caution for two reasons. First, these results are based on studies of low methodological quality. Second, the c...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
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