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Value of CT- Scanner in the diagnosis of acute appendicitis

SUMMARY:

Acute appendicitis is most common in emergency surgical abdominal pathology. CT- Scanner is usually applied in atypical form of acute appendicitis which making difficult for diagnosis. Prompt CT-Scanner diagnosis can reduce the follow–up time, exclude the wrong so as justify the perforated one.

Objective: Imaging description and assess the value of CTScanner in diagnosis of acute appendicitis.

Subjects and Methods: Cross-section descriptions of 92 subjects were clinically diagnosed pre-operation. CT scanner was carried out also before surgery. The CT-Scanner results was confronted to results of surgery and anatomopathology. Study performed in the Department of Surgery of Bach Mai Hospital from December 2008 to July 2010.

Results: The average diameter of the appendix inflammation was 10.32 ± 0.49 mm (min 5 mm, max 30 mm). Inflamed appendix diameter was more than 6 mm (83.5%) and wall thickness more than 2 mm (85.7%). Fat infiltration and fluid around the appendix was 84.6% and 50.5%, respectively. Appendix high density was compared with caecum (29.7%) and appendix enhancement was 89.0%. Thickness of caecum localized around the base of the appendix (26.4%). Stone of appendix, ganglion mesentericum and perforation complication were seen in 38.5%, 12.9% and 29.7%, respectively. Conclusion: The CT-Scanner was very effective in diagnsosis of appendicitis, especially in difficult cases. It confirmed the location, size and complications of appencitis. The value of this modality is higher than US. Key words: Acute Appendicitis, Acute abdominal pain, CT scanner.