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CT Abdomen in Appendicitis

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1. CT Abdomen in Appendicitis

CT Abdomen in Appendicitis CT Abdomen in Appendicitis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 CT Abdomen in Appendicitis CT (...) Abdomen in Appendicitis Aka: CT Abdomen in Appendicitis II. Indications Suspected III. Technique Focused below lower pole of right with IV contrast alone is sufficient in most cases Similar efficacy in diagnosis with IV contrast alone when compared with IV and may be indicated in thin patients (without adequate fatty tissue) or when abscess is suspected IV. Interpretation Signs suggestive of Fat streaking Appendix exceeds 6 mm in diameter Fluid filled peripheral enhancing tubular structure RLQ

2018 FP Notebook

2. Concomitant leukocytosis and lymphopenia predict significant pathology at CT of acute abdomen: a case-control study. (PubMed)

Concomitant leukocytosis and lymphopenia predict significant pathology at CT of acute abdomen: a case-control study. Acute abdominal pain accounts for about 10% of emergency department visits and has progressively become the primary indication for CT scanning in most centers. The goal of our study is to identify biological or clinical variables able to predict or rule out significant pathology (conditions requiring urgent medical or surgical treatment) on abdominal CT in patients presenting (...) to an emergency department with acute abdominal pain.This was a retrospective cohort study performed in the emergency department of an academic center with an annual census of 60'000 patients. One hundred and-nine consecutive patients presenting with an acute non-traumatic abdominal pain, not suspected of appendicitis or renal colic, during the first semester of 2013, who underwent an abdominal CT were included. Two medical students, completing their last year of medical school, extracted the data from

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2019 BMC Emergency Medicine

3. Harms of CT scanning prior to surgery for suspected appendicitis

appendectomies, this at the cost of one radiation-induced cancer death. One cancer death from imaging to prevent no surgical deaths from negative appendectomy is a trade-off that should lead us to question reflexive CT scanning of patients we suspect of having appendicitis. It is unfortunate that there are no randomised trials comparing the management of suspected appendicitis with and without CT scanning. As CT scanners capable of imaging the abdomen became more available, their use in the evaluation (...) Harms of CT scanning prior to surgery for suspected appendicitis Harms of CT scanning prior to surgery for suspected appendicitis | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your

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2015 Evidence-Based Medicine (Requires free registration)

4. Imaging Possible Appendicitis With CT

Imaging Possible Appendicitis With CT Imaging Possible Appendicitis With CT - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Imaging Possible Appendicitis With CT (IMPACT) The safety and scientific validity (...) : Pain in the right lower abdomen is one of the commonest reasons patients present to general surgeons as an emergency. Whether or not such patients have appendicitis is crucial to their assessment. In UK practice, when the diagnosis is unclear, ultrasound scanning (US) is commonly used to investigate the problem. US is very safe but it will only visualise the appendix in the minority of cases. As a result, the sensitivity for diagnosing appendicitis in this setting is probably only 5-30

2018 Clinical Trials

5. Appropriate Use Criteria: Imaging of the Abdomen and Pelvis

Appendicitis Advanced imaging is considered medically necessary in EITHER of the following scenarios: ? Diagnosis of suspected appendicitis ? Perioperative management IMAGING STUDY - Nonpregnant adults ? CT abdomen and pelvis - Pregnant women ? Ultrasound required for initial evaluation ? MRI abdomen and pelvis when ultrasound is nondiagnostic ? CT abdomen and pelvis when ultrasound is nondiagnostic and MRI is contraindicated or unavailable - Pediatric patients ? Ultrasound recommended for initial (...) evaluation ? CT or MRI abdomen and/or pelvis when ultrasound is unavailable or is expected to be limited due to body habitus Rationale The incidence of acute appendicitis is estimated at 3.4 million cases per year in the U.S. Typical signs and symptoms, including right lower quadrant pain, fever, anorexia, nausea, and vomiting, should lead to surgical consultation. When the diagnosis cannot be made on clinical exam alone, imaging modalities including ultrasound, CT, and MRI may be indicated. Alternative

2019 AIM Specialty Health

6. An Acute Abdomen Mimicking Appendicitis (PubMed)

An Acute Abdomen Mimicking Appendicitis 30038972 2019 02 26 2514-8281 100 1 2016 Jan 29 Journal of the Belgian Society of Radiology J Belg Soc Radiol An Acute Abdomen Mimicking Appendicitis. 11 10.5334/jbr-btr.1009 Malasi Sokol S UZ Brussel, BE. Kadi Redouane R UZ Brussel, BE. Haven Frederic F Cliniquesdeleurope, BE. Matthys Peter P Cliniquesdeleurope, BE. eng Case Reports 2016 01 29 England J Belg Soc Radiol 101698198 2514-8281 Appendix CT Mucocele Pseudomyxoma 2018 7 25 6 0 2016 1 29 0 0 2016

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2016 Journal of the Belgian Society of Radiology

7. Acute appendicitis

Acute appendicitis Acute appendicitis - Symptoms, diagnosis and treatment | BMJ Best Practice   Search  Acute appendicitis Last reviewed: February 2019 Last updated: June 2018 Summary Acute inflammation of the vermiform appendix. Typically presents as acute abdominal pain starting in the mid-abdomen and later localising to the right lower quadrant. Associated with fever, anorexia, nausea, vomiting, and elevation of the neutrophil count. Diagnosis is usually made clinically. If investigation (...) is required, CT scan or ultrasonography may show dilatation of the appendix outer diameter to more than 6 mm. Definitive treatment is surgical appendectomy. Definition Acute appendicitis is an acute inflammation of the vermiform appendix, Fitz RH. Perforating inflammation of the vermiform appendix with special reference to its early diagnosis and treatment. Am J Med Sci. 1886;92:321-346. most likely due to obstruction of the lumen of the appendix (by faecolith, normal stool, infective agents, or lymphoid

2018 BMJ Best Practice

8. Appropriate Use Criteria: Imaging of the Abdomen & Pelvis

. AIM Specialty Health. All Rights Reserved. 2 Table of Contents Description and Application of the Guidelines 3 Administrative Guidelines 4 Ordering of Multiple Studies 4 Pre-test Requirements 5 Abdominal & Pelvic Imaging 6 CT of the Abdomen 6 MRI of the Abdomen 15 MRCP of the Abdomen 20 CTA/MRA of the Abdomen 22 CTA Abdominal Aorta and Bilateral Illiofemoral Lower Extremity Run-off 26 CT of the Pelvis 28 MRI of the Pelvis 35 Fetal MRI 41 CTA/MRA of the Pelvis 43 CT of the Abdomen & Pelvis (...) Combination 45 CTA of the Abdomen & Pelvis Combination 51 CT Colonography (Virtual Colonscopy) 54Guideline Description and Administrative Guidelines | Copyright © 2018. AIM Specialty Health. All Rights Reserved. 3 AIM’s Clinical Appropriateness Guidelines (hereinafter “AIM’s Clinical Appropriateness Guidelines” or the “Guidelines”) are designed to assist providers in making the most appropriate treatment decision for a specific clinical condition for an individual. As used by AIM, the Guidelines establish

2018 AIM Specialty Health

9. Appendicitis

of this page. But if you still have questions please contact us via jon.brassey@tripdatabase.com Appendicitis Appendicitis is an inflammation of the appendix. Both children and adults can suffer from appendicitis. If untreated the appendix can perforate, causing the release of infectious material in the body, which can be life threatening. Symptoms and causes of appendicitis Common symptoms of appendicitis include sharp pain in the abdomen, loss of appetite, fever, severe cramps, diarrhoea and nausea (...) peritonitis, appendix mass or abscess, adhesions, sepsis, and death. However, the prognosis is good if the person 2016 2. Acute appendicitis Acute appendicitis - Symptoms, diagnosis and treatment | BMJ Best Practice   Search  Acute appendicitis Last reviewed: August 2018 Last updated: June 2018 Summary Acute inflammation of the vermiform appendix. Typically presents as acute abdominal pain starting in the mid-abdomen and later localising to the right lower quadrant. Associated with fever, anorexia

2018 Trip Latest and Greatest

10. Suspected Appendicitis?Child

Suspected Appendicitis?Child New 2018 ACR Appropriateness Criteria ® 1 Suspected Appendicitis–Child American College of Radiology ACR Appropriateness Criteria ® Suspected Appendicitis–Child Variant 1: Child. Suspected acute appendicitis, low clinical risk. Initial imaging. Procedure Appropriateness Category Relative Radiation Level CT abdomen and pelvis with IV contrast Usually Not Appropriate ?? ?? CT abdomen and pelvis without and with IV contrast Usually Not Appropriate ?? ?? ? CT abdomen (...) and with IV contrast Usually Not Appropriate ?? ?? ? US pelvis Usually Not Appropriate O ACR Appropriateness Criteria ® 2 Suspected Appendicitis–Child Variant 3: Child. Suspected acute appendicitis, high clinical risk. Initial imaging. Procedure Appropriateness Category Relative Radiation Level CT abdomen and pelvis with IV contrast May Be Appropriate ?? ?? MRI abdomen and pelvis without IV contrast May Be Appropriate O US abdomen RLQ May Be Appropriate O CT abdomen and pelvis without IV contrast May

2019 American College of Radiology

11. AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Abdomen and/or Retroperitoneum

. Hyperamylasemia and acute pancreatitis. In: Bluth EI, Benson CB, Ralls PW, Siegel MJ (eds). ?Ultrasound: A Practical Approach to Clinical Problems ?. 2nd ed. New York, NY: Thieme; 2008:74–83. 19. Doria AS, Daneman A, Moineddin R, et al. High-frequency sonographic patterns of the spleen in children. ?Radiology ? 2006; 240:821–827. 20. Sutherland T, Temple F, Hennessy O, Lee WK. Abdomen’s forgotten organ: sonography and CT of focal splenic lesions. ?J Med Imaging Radiat Oncol ? 2010; 54:120–128. 21. Siegel MJ (...) AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Abdomen and/or Retroperitoneum 1 AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Abdomen and/or Retroperitoneum Parameter developed in conjunction with the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Radiologists in Ultrasound (SRU). The American Institute of Ultrasound in Medicine (AIUM) is a multidisciplinary association

2017 American Institute of Ultrasound in Medicine

12. Right Lower Quadrant Pain : Suspected Appendicitis

Right Lower Quadrant Pain : Suspected Appendicitis Revised 2018 ACR Appropriateness Criteria ® 1 Right Lower Quadrant Pain–Suspected Appendicitis American College of Radiology ACR Appropriateness Criteria ® Right Lower Quadrant Pain-Suspected Appendicitis Variant 1: Right lower quadrant pain, fever, leukocytosis. Suspected appendicitis. Initial imaging. Procedure Appropriateness Category Relative Radiation Level CT abdomen and pelvis with IV contrast Usually Appropriate ??? CT abdomen (...) : Right lower quadrant pain, fever, leukocytosis. Possible appendicitis. Atypical presentation. Initial imaging. Procedure Appropriateness Category Relative Radiation Level CT abdomen and pelvis with IV contrast Usually Appropriate ??? CT abdomen and pelvis without IV contrast May Be Appropriate ??? US abdomen May Be Appropriate O US pelvis May Be Appropriate O MRI abdomen and pelvis without and with IV contrast May Be Appropriate O MRI abdomen and pelvis without IV contrast May Be Appropriate O CT

2018 American College of Radiology

13. CT Findings of Foreign Body Reaction to a Retained Endoloop Ligature Plastic Tube Mimicking Acute Appendicitis: A Case Report (PubMed)

around air-containing tubular structure mimicked acute appendicitis on abdomen computed tomography (CT), one year after laparoscopic cholecystectomy. We reported CT findings of foreign body reaction related to retained Endoloop ligature plastic tube mimicking acute appendicitis. (...) CT Findings of Foreign Body Reaction to a Retained Endoloop Ligature Plastic Tube Mimicking Acute Appendicitis: A Case Report Many hospitals experience one or more retained surgical instrument events with risk of patient morbidity and medicolegal problems. Identification of retained surgical instrument is important. The radiologists should be familiar with imaging finding of retained surgical instrument. In a 62-year-old female with a retained plastic tube, localized peritoneal infiltration

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2016 Korean Journal of Radiology

14. CRACKCast E093 – Appendicitis

the surgeon with surgical planning Helps look for alternative diagnoses Rapid Gold standard test Drawbacks: Risk for false-negative studies in thin patients (less intra-abd. fat) or special circumstances (tip appendicitis) Radiation!! (2-10 mSv) Logistical (if you don’t have a CT scanner) “The greatest disadvantage of CT is the ionizing radiation. A CT scan of the abdomen exposes the patient to an average dose of ionizing radiation equivalent to 8 examination 10 mSv. To put this in perspective (...) % of female patient with appendicitis. A rectal examination contributes little toward the assessment of appendicitis and is not routinely recommended ” Here are the Top three: “RLQ tenderness; Abdominal wall rigidity; Pain focused at McBurney’s point” See wisecracks for the atypical presentations! 4) List 2 advantages and disadvantages each for CT and US in the diagnosis of appendicitis. What is the sensitivity/specificity of ↑WBC? Ultrasound: sensitivities of 75% to 90%, specificities of 83% to 95

2017 CandiEM

15. Computed tomography to rule out suspected appendicitis in adults and reduce the negative appendectomy rate

suspected appendicitis in adults and reduce the negative appendectomy rate: August 2016 1 Technology, Company and Licensing Register ID WP233 Technology name Computed tomography Patient indication Adults with acute abdomen and suspected appendicitis Description of the technology Computed tomography (CT) is an imaging technique that uses x-rays to create cross- sectional images of the body. Unlike conventional x-rays which utilise a fixed x-ray tube, CT scanners use a motorised x-ray source that rotates (...) cases, CT may be performed with the assistance of contrast agents to help to visualise soft tissue by increasing opacity to produce clearer images. Contrast agents, such as iodine or barium-based compounds, are typically administered orally, intravenously or rectally. Sudden and severe abdominal pain, also known as acute abdomen, is a common complaint among patients presenting to an emergency department and may result from acute cholecystitis, acute appendicitis, acute pancreatitis

2016 COAG Health Council - Horizon Scanning Technology Briefs

16. Diagnosis of Right Lower Quadrant Pain and Suspected Acute Appendicitis

performance of imaging tests for the diagnosis of acute appendicitis 66 Table 20. Meta-regression results for factors that affect the performance of imaging tests for the diagnosis of acute appendicitis 71 Table 21. Meta-regression results for the impact of risk of bias items on the estimated test performance of imaging tests for the diagnosis of acute appendicitis 76 Table 22. Test performance comparisons in randomized trials – CT versus standard of care 85 Table 23. Test performance comparisons (...) appendicitis 63 Figure 9. Scatterplot of results in the receiver operating characteristic space and summary receiver operating characteristic curves for selected imaging tests for the diagnosis of acute appendicitis 68 Figure 10. Positive predictive value and negative predictive value curves for selected imaging tests for the diagnosis of acute appendicitis 69 Figure 11. Test performance results in studies evaluating both CT and US as index tests 88 Figure 12. Receiver operating characteristic curves from

2016 Effective Health Care Program (AHRQ)

17. CT Abdomen in Appendicitis

CT Abdomen in Appendicitis CT Abdomen in Appendicitis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 CT Abdomen in Appendicitis CT (...) Abdomen in Appendicitis Aka: CT Abdomen in Appendicitis II. Indications Suspected III. Technique Focused below lower pole of right with IV contrast alone is sufficient in most cases Similar efficacy in diagnosis with IV contrast alone when compared with IV and may be indicated in thin patients (without adequate fatty tissue) or when abscess is suspected IV. Interpretation Signs suggestive of Fat streaking Appendix exceeds 6 mm in diameter Fluid filled peripheral enhancing tubular structure RLQ

2015 FP Notebook

18. Abdomen CT and Open Appendicectomy:New Diagnostic and Surgical Procedures

Abdomen CT and Open Appendicectomy:New Diagnostic and Surgical Procedures Abdomen CT and Open Appendicectomy:New Diagnostic and Surgical Procedures - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Abdomen (...) by (Responsible Party): weng xinhai, Ningbo Municipal No.4 Hospital Study Details Study Description Go to Brief Summary: The traditional open appendectomy in the clinical effect is not prefect, and for a long time there is no measurable improvement. The application of abdomen CT before surgery provides a new approach to the incision and new perception. In a randomized controlled trial of modified incision versus traditional incision. Length of hospital day was the primary terminus, while operating time

2015 Clinical Trials

19. Intestinal necrosis cannot be neglected in a patient with hepatic portal vein gas combined with appendicitis: a rare case report and literature review. (PubMed)

Intestinal necrosis cannot be neglected in a patient with hepatic portal vein gas combined with appendicitis: a rare case report and literature review. Hepatic portal vein gas (HPVG) is a rare acute abdomen, which is not an independent disease. Meanwhile, HPVG combined with appendicitis has been rarely reported. We found only a similar report by looking for literature, but no intestinal necrosis occurred. We report a patient with HPVG, appendicitis and intestinal necrosis was reported (...) in the current study. The patient was given frequent monitoring and had been conducted operation in time.An 86-year-old female with appendicitis complicated by HPVG was reported in the present study. Abdominal examination revealed rebound tenderness at the McBurney's point. Moreover, abdominal computed tomography (CT) revealed gas in portal and mesenteric veins in addition to appendicitis. An emergency operation was planned on the appendix. However, the patient refused surgical treatment. Therefore

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2019 BMC Surgery

20. Diagnostic accuracy of pediatric atypical appendicitis: Three case reports. (PubMed)

Diagnostic accuracy of pediatric atypical appendicitis: Three case reports. Acute appendicitis is one of the most common causes of acute abdomen in children, yet it is difficult to diagnose in young children because its clinical manifestations may be atypical. Here, 3 atypical clinical cases associated with appendicitis in children are reported.The 1st case corresponds to a 5-year-old male patient who presented with abdominal discomfort, intermittent fevers, and vomiting, have increased white (...) blood cell (WBC) count and C-reactive protein (CRP). The second case is a 7-year-old male patient who began with intermittent fevers and lower quadrant abdominal pain, showing increased WBC count and CRP. The 3rd case corresponds to a 7-year-old female patient who presented with intermittent fevers, abdominal pain, and forebreast discomfort, demonstrating increased WBC count and CRP.Abdominal computed tomography (CT) scan presented data suggestive of enlarged appendix in diameter, and stercolith

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2019 Medicine

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