It can be difficult to assess whether a patient is experiencing acute appendicitis or has an intestinal upset. CT, or computed tomography, scans can help determine if the patient needs to have his or her appendix removed.
However, while having a clear picture showing the appendix confirms patient and physician suspicions, the time required to conduct the scan delays time to a potential operation, with the risk that the appendix could perforate while the patient awaits the test results.
Researchers at the University of Wisconsin in Madison, Wis. evaluated the differences between patients who received a CT scan before removal of their appendix and those who went directly to surgery without the test.
In this study, investigators reviewed the hospital records for 412 adult patients admitted to University of Wisconsin Hospital during a three-year period. The researchers compared the white blood cell counts taken from patients both upon arrival to the emergency room and at the operating room. Of the 410 patients showing signs of acute appendicitis, more than half (62%) had a CT scan before the removal of their appendix.
Patients who were ordered a CT scan were older, more likely to be female and had experienced a longer waiting period between admittance and surgery than those who were not ordered a scan (8.2 vs. 5.1 hours). Additionally, perforation was seen in 17 percent of those who had a CT scan, while only eight percent of those who did not get a CT scan experienced perforation.
“These findings suggest that pre-operative CT scanning in patients experiencing acute appendicitis symptoms should be used selectively,” said Herbert Chen, M.D., of University of Wisconsin and lead author of the study. “CT imaging may delay surgery, increasing the likelihood of the appendix rupturing and causing potentially dangerous complications for the patient.”