Appendicitis

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  • Published : January 17, 2013
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Abstract
Background: Considered as one of the most common diseases in emergency abdominal surgery, acute appendicitis affects approximately seven percent of the population with an estimate of eighteen percent of perforation rates. Checking a patient who has suspicion of acute appendicitis primarily depends on the patient’s history of disease and physical signs. Clinical manifestation, however, is rare evidence when deciding to check an individual for acute appendicitis.

2871 adults who were suspected of having appendicitis were sent to an academic medical center. At the center, they received nonspecific multidetector computed tomography or CT scanning of their abdominal and pelvic areas. These procedures took place within 24 to 48 hours of patient arrival. Radiologists reviewed the computed tomography images and concluded which patients displayed manifestations of acute appendicitis and which patients did not. Once no signs or symptoms of acute appendicitis were found, the radiologists proposed alternative diagnosis for patients without signs. A procedure referred to as appendectomy was administered for those patients in which the radiologists diagnosed with acute appendicitis. Surgeons recorded whether or not acute appendicitis was actually the accurate analysis. These doctors followed up with patients who did not require surgery for a minimum of one year to dismiss a postponed diagnosis. The radiologists concluded that seven hundred and eight patients displayed enough signs to be diagnosed with acute appendicitis. However, the surgeons involved in the case study verified that only six hundred and sixty five patients were actually suffering from acute appendicitis. The radiologists also concluded that the diagnosis of acute appendicitis in 2163 of the participating patients could be excluded. Out of the large amount of patients who were not diagnosed with acute appendicitis, ten of them were later diagnosed with the inflammatory condition. Along with the increasing use of computed tomography, there has been a correlation of decreasing perforations of the appendix in patients with acute appendicitis. Perforations of the appendix coincide with delayed treatment. Therefore, according to The Role of Multidetector Computed Tomography for Diagnosing Acute Appendicitis, the fact that computed tomography scanning is capable of detecting early diagnosis of appendicitis suggests that the increasing use of multidetector computed tomography is the reason for the decrease in perforations of the appendix in patients suffering from acute appendicitis (Pickhardt, Lawrence, Pooler & Bruce, 2011). Considered as one of the most common diseases in emergency abdominal surgery, acute appendicitis occurs approximately seven percent in a lifetime with an estimate of eighteen percent of perforation rates. Checking a patient who has suspicion of acute appendicitis primarily depends on the patient’s history of disease and physical signs. Clinical manifestation, however, is rare evidence when deciding to check an individual for acute appendicitis. Occasionally, a patient will not be diagnosed with acute appendicitis because more evidence is needed to determine whether or not the patient’s condition is, in fact, acute appendicitis. Unfortunately, when this delay is in process, patients may suffer from other severe complications of another condition such as peritonitis. Mortality and morbidity rates for patients that undergo this occurrence are much higher than patients who are diagnosed with acute appendicitis in a timely fashion. In other words, diagnosis and treatment of acute appendicitis must be accurate and completed within an appropriate time frame to decrease the chances of unnecessary diagnostic procedures. Proper therapeutic measures and clinical management strategies must be identified and implemented in an appropriate time frame as well. Significant factors that contribute to acute appendicitis are difficult...
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