Acute appendicitis is one of the most frequently suspected acute abdominal conditions in the emergency department and the most common indication for emergency abdominal surgery. Ultrasound (US) is the modality of choice in patients with suspected appendicitis due to its low price, accessibility, lack of ionising radiation and generally good diagnostic accuracy reported in the literature, albeit with a wide range of sensitivity and specificity reported. The principal limitation of the US is its diagnostic variability, highly dependent on the radiologist/operator skills and experience, and...

This is a retrospective analysis of consecutive patients who underwent appendectomy with suspected acute appendicitis between January 2017 and August 2018. Patient’s demographics, clinical, histopathology and preoperative radiology reports were reviewed. The normal appendix is a blind-ended tubular structure, originating from the base of the cecum, non-peristaltic, tubular structure with wall thickness <3 mm, outer diameter <6 mm and is compressible. In our institution diagnosis of acute appendicitis is made in the appropriate clinical scenario, using standard graded compression technique on the visualisation of a...

In the period considered a total of 311 patients underwent appendectomy for suspected acute appendicitis. Patients were aged between 3 and 96 years old, with an average age of the cohort of 34 years. The sample was divided into 3 groups of age as shown in Table 1. The majority of patients were adults (excluding senior adults), with a slight predominate of males (59.5%). Preoperative imaging was solicited in 88.7% of the suspected cases of acute appendicitis, with ultrasound as a first line request in...

In our centre pre-operative imaging has a high usage, particularly ultrasound which demonstrated to be a reliable modality, allowing the visualisation of the appendix in a large majority of clinically significant cases, with high sensitivity and PPV. The use of CT was restricted mostly to unavailability of US (night shift) and some inconclusive US reports. In the past, a negative appendectomy rate between 15-25% was considered acceptable. However, with extensive use of pre-surgical imaging modalities, NAR has dropped to as low as 1.7%. In our...

Pedro M. Sousa, first-year Radiology Resident at Hospital Beatriz Ângelo, Loures (PT). Email: [email protected]

Kessler N, Cyteval C, Gallix B, Lesnik A, Blayac PM, Pujol J, et al. Appendicitis: Evaluation of sensitivity, specificity and predictive values of US, Doppler US and laboratory findings. Radiology (2003); 230:472-478. Doria AS, Moineddin R, Kellenberger CJ, Epelman M, Beyene J, et al. US or CT for Diagnosis of Appendicitis in Children and Adults? A Meta-Analysis. Radiology (2006); 241(1):83-94. Hernanz-Schulman M. CT and US in the Diagnosis of Appendicitis : An Argument for CT. Radiology (2010); 255(1):3-7. George T, Rajan B, Thomas PT. Reability...