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Review article

Imaging acute appendicitis: state of the art

Diana Gaitini
Date of Submission: 29-Jun-2011, Date of Acceptance: 21-Sep-2011, Date of Web Publication: 07-Oct-2011.
Corresponding Author:
Corresponding Author

Diana Gaitini

E-mail: d_gaitini@rambam.health.gov.il

Corresponding Author:
Corresponding Author

Diana Gaitini

E-mail: d_gaitini@rambam.health.gov.il

DOI: 10.4103/2156-7514.85778 Facebook Twitter Google Linkedin


The goal of this review is to present the state of the art in imaging tests for the diagnosis of acute appendicitis. Relevant publications regarding performance and advantages/disadvantages of imaging modalities for the diagnosis of appendicitis in different clinical situations were reviewed. Articles were extracted from a computerized database (MEDLINE) with the following activated limits: Humans, English, core clinical journals, and published in the last five years. Reference lists of relevant studies were checked manually to identify additional, related articles. Ultrasound (US) examination should be the first imaging test performed, particularly among the pediatric and young adult populations, who represent the main targets for appendicitis, as well as in pregnant patients. A positive US examination for appendicitis or an alternative diagnosis of possible gastrointestinal or urological origin, or a negative US, either showing a normal appendix or presenting low clinical suspicion of appendicitis, should lead to a final diagnosis. A negative or indeterminate examination with a strong clinical suspicion of appendicitis should be followed by a computed tomography (CT) scan or alternatively, a magnetic resonanace imaging (MRI) scan in a pregnant patient. A second US examination in a patient with persistent symptoms, especially if the first one was performed by a less experienced imaging professional, is a valid alternative to a CT.
Keywords: Abdominal Imaging, Appendicitis, Compression Ultrasound, Magnetic Resonance Imaging, Multidetector Computed Tomography

Cited in 14 Documents

  1. Abraham H. Dachman Improving the Role of CT in Diagnosing Perforated Appendicitis Academic Radiology 19(10) 2012 1173. Doi: 10.1016/j.acra.2012.07.004
  2. Hamid Tayebi Khosroshahi, Behzad Abedi, Sabalan Daneshvar, Yashar Sarbaz and Abolhassan Shakeri Bavil Future of the Renal Biopsy: Time to Change the Conventional Modality Using Nanotechnology International Journal of Biomedical Imaging 2017 2017 1. Doi: 10.1155/2017/6141734
  3. A. N. Sridhar, M. Andrikopoulou, L. Clarke, C. Ashley, P. Mekhail and U. A. Khan Impact of the Increased Use of Preoperative Imaging and Laparoscopy on Appendicectomy Outcomes Indian J Surg 77(S2) 2015 356. Doi: 10.1007/s12262-013-0842-3
  4. Julia M. Hobbs Diagnostic Imaging of Appendicitis With Supplementation by Transabdominal and Transvaginal Sonography Journal of Diagnostic Medical Sonography 31(6) 2015 345. Doi: 10.1177/8756479315611656
  5. Ashkan Shademan and Rafel FR Tappouni Pitfalls in CT diagnosis of appendicitis: Pictorial essay Journal of Medical Imaging and Radiation Oncology 57(3) 2013 329. Doi: 10.1111/j.1754-9485.2012.02451.x
  6. Abhay Srinivasan, Sabah Servaes, Andrès Peña and Kassa Darge Utility of CT after sonography for suspected appendicitis in children: integration of a clinical scoring system with a staged imaging protocol Emerg Radiol 22(1) 2015 31. Doi: 10.1007/s10140-014-1241-1
  7. Mark W. Maxfield, Kevin M. Schuster, Jamal Bokhari, Edward A. McGillicuddy and Kimberly A. Davis Predictive factors for failure of nonoperative management in perforated appendicitis Journal of Trauma and Acute Care Surgery 76(4) 2014 976. Doi: 10.1097/TA.0000000000000187
  8. M.M. Moore, A.N. Kulaylat, J.M. Brian, A. Khaku, M.A. Hulse, B.W. Engbrecht, S.T. Methratta and D.K.B. Boal Alternative diagnoses at paediatric appendicitis MRI Clinical Radiology 70(8) 2015 881. Doi: 10.1016/j.crad.2015.03.001
  9. Kwang Baek Kim, Hyun Jun Park, Doo Heon Song and Sang-suk Han Developing an Intelligent Automatic Appendix Extraction Method from Ultrasonography Based on Fuzzy ART and Image Processing Computational and Mathematical Methods in Medicine 2015 2015 1. Doi: 10.1155/2015/389057
  10. Alessia Ferrarese, Alessandro Falcone, Mario Solej, Dario Bono, Paolo Moretto, Najada Dervishi, Veltri Andrea, Stefano Enrico, Mario Nano and Valter Martino Surgeon's clinical valuation and accuracy of ultrasound in the diagnosis of acute appendicitis: A comparison with intraoperative evaluation. Five years experience International Journal of Surgery 33 2016 S45. Doi: 10.1016/j.ijsu.2016.05.052
  11. Lulu He, Ellen Park, Neil Vachhani, Esben Vogelius, Chakradhar Thupili and Unni Udayasankar Acute abdominal pain in children: usefulness of three-view abdominal radiographs in the emergency department Emerg Radiol 23(5) 2016 469. Doi: 10.1007/s10140-016-1423-0
  12. Suhail Aslam Khan, Haseeb Anwar Khokhar, A.R.H. Nasr and Eleanor Carton Incidence of right-sided colonic tumors (non-appendiceal) in patient's ≥40 years of age presenting with features of acute appendicitis International Journal of Surgery 11(4) 2013 301. Doi: 10.1016/j.ijsu.2013.02.004
  13. Grazia Loretta Buquicchio, Gavina Cuneo, Stefano Giannecchini, Caterina Pizzi, Carmelo Rende and Margherita Trinci Imaging Non-traumatic Abdominal Emergencies in Pediatric Patients (Chapter 10) 2016 149. Doi: 10.1007/978-3-319-41866-7_10
  14. Shao Jin Ong, Siobhan Whitley, Hesham Safar-Aly and Rudi Borgstein Imaging the patient with suspected appendicitis British Journal of Hospital Medicine 73(Sup12) 2012 C178. Doi: 10.12968/hmed.2012.73.Sup12.C178

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