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DOI: 10.1016/j.rxeng.2020.10.009
Available online 22 May 2021
The usefulness and positive predictive value of ultrasonography and computed tomography in the diagnosis of acute appendicitis in adults: A retrospective study
Estudio retrospectivo y comparativo de la utilidad y del valor predictivo positivo de la ecografía y la tomografía computarizada en el diagnóstico de apendicitis aguda en adultos
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M.A. Depetrisa, E. Martínez Chamorroa, L. Ibáñez Sanza, J.C. Albillos Merinoa, E. Rodríguez Cuellarb, S. Borruel Nacentaa,
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sborruel.hdoc@salud.madrid.org

Corresponding author.
a Servicio de Radiodiagnóstico, Hospital Universitario 12 de Octubre, Madrid, Spain
b Servicio de Cirugía General, Hospital Universitario 12 de Octubre, Madrid, Spain
Received 07 May 2020. Accepted 13 October 2020
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Tables (6)
Table 1. Demographic characteristics and mean hospital stay of the two samples.
Table 2. Pathology of appendectomies.
Table 3. Severity of cases of acute appendicitis.
Table 4. Variation in the use of imaging tests in the two periods compared.
Table 5. Predictive positive values for 2015.
Table 6. Predictive positive values for 2007.
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Abstract
Objective

To analyze the evolution of the use of imaging tests (ultrasonography and computed tomography (CT)) in the diagnosis of acute appendicitis. To determine the positive predictive value of these tests and the percentage of negative and complicated appendectomies.

Material and methods

This retrospective study compared adults who underwent appendectomy for suspected acute appendicitis at our tertiary hospital during 2015 versus similar patients at our center during 2007.

Results

A total of 278patients were included. The rate of negative appendectomies descended to 5%. The positive predictive value of ultrasonography increased to 97.4% in 2015, and the positive predictive value of CT and combined CT and ultrasonography was 100%. The rate of complicated appendicitis increased (23% in 2015).

Conclusions

The use of imaging tests increased, and the rate of “blind” laparotomies decreased. Nevertheless, the rate of complicated appendicitis increased.

Keywords:
Acute appendicitis
Ultrasonography
Computed tomography
Negative appendectomy
Perforated appendicitis
Gangrenous appendicitis
Resumen
Objetivo

Analizar la evolución del uso de pruebas de imagen (ecografía y tomografía computarizada [TC]) en el diagnóstico de apendicitis aguda, determinar el valor predictivo positivo (VPP) y el porcentaje de apendicectomías negativas y complicadas.

Material y métodos

Estudio retrospectivo que incluye a los pacientes adultos con apendicectomía por sospecha de apendicitis aguda en 2015 en un hospital terciario. Se compara con los datos obtenidos en el 2007, publicados previamente.

Resultados

La muestra incluye 278pacientes. La tasa de apendicectomías negativas descendió a un 5%. El VPP de la ecografía aumentó a 97,4% en 2015 y el VPP de la TC y del uso combinado de la ecografía y la TC fue del 100%. El porcentaje de apendicitis complicadas se incrementó (23% en 2015).

Conclusiones

Se observó un aumento en el empleo de pruebas de imagen y una disminución de laparotomías en blanco. No obstante, las apendicitis complicadas se han incrementado.

Palabras clave:
Apendicitis aguda
Ecografía
TC
Apendicectomías negativas
Apendicitis perforada
Apendicitis gangrenosa

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