The value of limited computed tomography with rectal contrast in the diagnosis of acute appendicitis

BACKGROUND: Multiple nonrandomized studies demonstrate the accuracy of comp uted tomography (CT) scan in diagnosing appendicitis. This study compared C T scan with standard management in diagnosing appendicitis. METHODS: This was a prospective randomized study of patients who received g eneral surgery consultation for appendicitis. Patients were randomized to r eceive CT scan or standard management. RESULTS: There were 65 patients in the CT scan group and 63 patients in the standard management group. The sensitivity, specificity, and accuracy of C T scan were 94%, 100%, and 96%, respectively. CT scan positively altered th e management in 26% and made alternative diagnoses in 14%. The sensitivity, specificity, and accuracy of the standard management group were 100%, 79%, and 89%, respectively. The standard management group had a negative append ectomy rate of 19%. CONCLUSIONS: CT scan with rectal contrast is an effective method for diagno sing appendicitis and should be performed in all patients suspected of havi ng appendicitis. (C) 2001 by Excerpta Medica, Inc.