Díaz SME, Onofre CJ, Treviño FRJ

Language: Spanish
References: 9
Page: 194-199
PDF size: 516.71 Kb.

ABSTRACT

Purpose. Acute abdominal pain due to possible acute appendicitis (AP) is one of the leading causes of care in emergency wards. Early and opportune diagnosis of acute appendicitis substantially lowers morbimortality in this kind of patients. Computed tomography (CT) is a highly sensitive and specific image study to diagnose this condition (94-98%). Our purpose was to determine the efficacy of CT as the study of choice in diagnosing AP contrasting its results with anatomopathological and surgical findings.
Material and methods. Patients who were admitted to the Hospital Christus Muguerza (Monterrey, Nuevo Leon) emergency ward with suspected acute appendicitis and for whom a CT was ordered to complement the diagnosis were studied. In all of them tomographic data of possible AP, direct and indirect, were identified, in both simple and contrasted studies. In cases where the result was positive, the information was contrasted with surgical and pathological findings (standard reference). In all cases the results were recorded in a 2 × 2 table to calculate sensitivity, specificity, and positive and negative predictive values.
Results. One hundred and five patients were studied, of whom 104 underwent surgery. Of the patients analyzed, 90% had a diagnosis, by CT, of acute appendicitis, and in that same 90% appendicitis was confirmed by pathological anatomy; in only two patients in whom the CT was positive for appendicitis was the final pathology result negative. According to the 2 × 2 table, a sensitivity of 99% and specificity of 97% were calculated for tomographic diagnosis of acute appendicitis at our hospital; the positive and negative predictive values were 91 and 66%, respectively.
Conclusion. CT at our hospital proved (in concordance with findings reported in the literature) high sensitivity and specificity for diagnosis of AP, and to identify related complications and facilitate prompt management of patients, lowering morbimortality.

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