Utility of Radiologic Imaging for Patients who underwent Appendectomy

ABSTRACT

PURPOSE: The primary aim of this study was to evaluate the rate of advanced radiographic imaging for patients who underwent appendectomy. The secondary aim was to investigate the effect of ultrasonography (US) and computed tomography (CT) on the outcome of an appendectomy. METHODS: We retrospectively reviewed the data of 585 patients who underwent an appendectomy as an emergency procedure in our hospital within a 2-year period. Cases were categorized by the presence or absence of advanced radiographic imaging. We evaluated the negative appendectomy rate, the occurrence of perforation, and the preoperative emergency department length of stay (ED LOS). RESULTS: Five hundred eighty-five (585) patients underwent operative exploration for presumed appendicitis. Of those 165 patients had no advanced imaging, 347 had a US, 49 had a CT scan, 24 had both US and a CT scan. Acute appendicitis was pathologically proven in 567 patients, corresponding to negative appendectomy rate of 3.1%. Ninetythree appendices (15.9%) were perforated. The mean preoperative ED LOS was 15.8 hours. CONCLUSION: Advanced radiographic imaging prior to operative exploration did not lower the negative appendectomy rate. Diagnostic imaging significantly increased the perforation rate and the preoperative ED LOS.