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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

Unit of Ultrasound, Department of Medical Imaging, Rambam Medical Center, Ha’aliya 8, POB 9602, Haifa, Israel.
E-mail: d_gaitini@rambam.health.gov.il

Corresponding Author:
Corresponding Author

Diana Gaitini

Unit of Ultrasound, Department of Medical Imaging, Rambam Medical Center, Ha’aliya 8, POB 9602, Haifa, Israel.
E-mail: d_gaitini@rambam.health.gov.il

DOI: 10.4103/2156-7514.85778 Facebook Twitter Google Linkedin

ABSTRACT


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

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