Imaging for suspected XXXX : negative appendectomy and perforation rates.

@entity1 @entity697 @entity698
PURPOSE: To determine which @entity1 suspected of having @entity697 benefit from preoperative imaging. MATERIALS AND METHODS: The medical records of 462 consecutive @entity1 who underwent appendectomy for clinically suspected @entity697 and underwent preoperative evaluation at our institution were retrospectively reviewed. @entity1 were divided into four groups: @entity1 (n = 166), @entity1 (n = 46), @entity1 (n = 178), and @entity1 (n = 72). Preoperative computed tomography (CT) or ultrasonography (US), requested by the referring clinician, was performed in 313 of the 462 @entity1 . Unnecessary, or negative, appendectomy and perforation rates were calculated for each group for preoperative evaluation with CT, with US, and with neither CT nor US. In addition, the sensitivity and positive predictive value of CT and US were calculated for diagnosing @entity698 . RESULTS: In @entity1 , the negative appendectomy rate was significantly lower for those who underwent preoperative CT (7% [six of 85 @entity1 ], P =.005) or US (8% [four of 49 @entity1 ], P =.019), as compared with 28% [nine of 32 @entity1 ] for those who underwent no preoperative imaging (P >.35 for all groups). The negative appendectomy rates for @entity1 , @entity1 , and @entity1 were not significantly affected by preoperative imaging. The sensitivity of CT and US for diagnosing @entity697 exceeded 93% and 77%, respectively, in all groups. The positive predictive values for both CT and US were greater than 92% in all groups. CONCLUSION: @entity1 suspected of having @entity698 benefit the most from preoperative CT or US, with a statistically significantly lower negative appendectomy rate than @entity1 who undergo no preoperative imaging. Therefore, we propose that preoperative imaging be considered part of the routine evaluation of @entity1 suspected of having @entity697 .
