Differential diagnosis to clinically suspected acute appendicitis patients underwent computed tomygraphy (CT) of abdomen at Phang-nga Hospital
Keywords:
Acute appendicitis, CT abdomenAbstract
Objective: To identify alternative diagnoses of clinically suspected acute appendicitis in emergency CT abdomen at Phang-nga Hospital
Materials and methods: Retrospective descriptive study was performed. Total 120 patients with clinically suspected acute appendicitis underwent emergency abdominal CT scan for further evaluation at Phang-nga Hospital from July 2016 to December 2018. Patients were also stratified by gender and age groups. Follow by correlated the image interpretation with final diagnosis on medical chart or pathological report in surgical cases. The statistical analysis was done by using SPSS program for frequency, mean, percentage. The Pearson Chi-square test and Fisher’s exact test were also used to analyze statistical significant (P<0.05)
Results: Of the 120 patients, appendicitis was diagnosed at emergency abdominal CT scan in 68 of 120 patients (56.7%), an alternative diagnosis was made at CT in 43 of 120 patients (35.8%). Non-specific diagnosis at CT was 9 of 120 patients (7.5%). Among the alternative diagnoses, the most common broad categories of disease detected at CT included non-appendiceal gastrointestinal conditions (11.7%), genitourinary conditions (9.2%), gynecologic condtiions (5.8%), and hepato-pancreatico-biliary conditions (4.2%). Sixty six of 111 patients (59.5%) who receiving a specific CT diagnosis underwent surgery or intervention compared with those patients who did not receive a specific diagnosis at CT, 0 of 9 patients (0%) underwent surgery.
Conclusion: Abdominal CT is a useful noninvasive method for diagnosis of clinically suspected acute appendicitis. This advantage is to get the correct diagnosis not only the most common cause; appendicitis but also other alternative diagnoses for proper treatment planning and management.
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