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Clinical guidelines, computed tomography scan, and negative appendectomies: a case series.

Chad Harswick·Amy Archer Uyenishi·Mary Frances Kordick·Shu B Chan
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Abstract

INTRODUCTION: Prior studies suggest that preoperative abdominal computed tomography (CT) scan can contribute to a low negative appendectomy rate. Our study objective was to evaluate cases of negative appendectomies for clinical criteria and CT use. METHODS: Retrospective 1-year study of all negative appendectomies at a community hospital. Data included clinical evidence for appendicitis as well as CT results if performed. RESULTS: Of 122 cases reviewed, 8 (6.6%) were negative appendectomies. Six were younger than 20 years. Four had a preoperative CT scan. Overall, 106 (87%) of 122 cases received preoperative CT and had a negative appendectomy rate of 3.8%. Sixteen cases did not have preoperative CT and had a negative appendectomy rate of 25% (odds ratio, 8.5; 95% confidence interval, 1.9-38.5; Fisher exact test P = .01). CONCLUSION: Patients who had a CT scan for suspected appendicitis had a lower rate of negative appendectomies than those who had no CT. Most of the negative appendectomies occurred in patients younger than 20 years.

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Abdominal PainAcute DiseaseAdolescentAdultAnorexiaAppendectomyAppendicitisChildChild, PreschoolFalse Positive ReactionsFemaleHumansMalePractice Guidelines as TopicPredictive Value of TestsRetrospective StudiesTomography, X-Ray ComputedCase ReportsJournal Article

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Chad Harswick, Amy Archer Uyenishi, Mary Frances Kordick, Shu B Chan. 2006. Clinical guidelines, computed tomography scan, and negative appendectomies: a case series.. https://doi.org/10.1016/j.ajem.2005.07.015

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