Appendiceal Intraluminal Gas: A CT Marker for Gangrenous Appendicitis
Introduction. This manuscript aims to investigate the amount of intraluminal gas in acute, nonperforated appendicitis identified on computed tomography (CT) in diagnosing gangrenous appendicitis. Methods. This is a retrospective observational, case-control study with consecutive data collected at a...
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| Language: | English |
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Wiley
2021-01-01
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| Series: | Radiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2021/7191348 |
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| author | Chantelle Ip Edward H. Wang Michael Croft Wanyin Lim |
| author_facet | Chantelle Ip Edward H. Wang Michael Croft Wanyin Lim |
| author_sort | Chantelle Ip |
| collection | DOAJ |
| description | Introduction. This manuscript aims to investigate the amount of intraluminal gas in acute, nonperforated appendicitis identified on computed tomography (CT) in diagnosing gangrenous appendicitis. Methods. This is a retrospective observational, case-control study with consecutive data collected at a tertiary institution over a two-year period, of patients with CT-diagnosed acute appendicitis who subsequently went on for surgery within 48 hours. Patients who were less than 16 years old, who had an interval between CT and surgery of more than 48 hours, or with CT evidence of appendiceal perforation were excluded. Images were independently assessed by 3 radiologists for intraluminal gas, and the results were then correlated with reference standards obtained from surgical and histopathology reports for the diagnosis of nongangrenous versus gangrenous appendicitis. The sensitivity, specificity, and predictive values of CT intraluminal gas in gangrenous appendicitis were calculated. Results. Our study identified 93 patients with nonperforated acute appendicitis who underwent surgery within the stated timeframe. Intraluminal gas in the appendix was identified in 26 patients (28%), of which 54% had macroscopic and/or microscopic evidence of gangrenous appendicitis. This is in contrast to the subgroup of patients who did not have intraluminal gas (72%), of which only 33% had gangrenous appendicitis. The specificity of intraluminal gas for gangrenous appendicitis is 79%, with a negative predictive value of 86% and likelihood ratio of 1.85. Conclusion. In cases of established acute appendicitis, the presence of intraluminal gas is a moderately specific sign for gangrenous complication. This is worth reporting as it can help prognosticate and triage patients accordingly, for a timelier surgical management and a better outcome. |
| format | Article |
| id | doaj-art-49de3a0d0ce44ab5beba0eecd53c5f26 |
| institution | Kabale University |
| issn | 2090-195X |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Radiology Research and Practice |
| spelling | doaj-art-49de3a0d0ce44ab5beba0eecd53c5f262025-02-03T01:10:08ZengWileyRadiology Research and Practice2090-195X2021-01-01202110.1155/2021/7191348Appendiceal Intraluminal Gas: A CT Marker for Gangrenous AppendicitisChantelle Ip0Edward H. Wang1Michael Croft2Wanyin Lim3Royal Adelaide HospitalFlinders Medical CentreRoyal Adelaide HospitalRoyal Adelaide HospitalIntroduction. This manuscript aims to investigate the amount of intraluminal gas in acute, nonperforated appendicitis identified on computed tomography (CT) in diagnosing gangrenous appendicitis. Methods. This is a retrospective observational, case-control study with consecutive data collected at a tertiary institution over a two-year period, of patients with CT-diagnosed acute appendicitis who subsequently went on for surgery within 48 hours. Patients who were less than 16 years old, who had an interval between CT and surgery of more than 48 hours, or with CT evidence of appendiceal perforation were excluded. Images were independently assessed by 3 radiologists for intraluminal gas, and the results were then correlated with reference standards obtained from surgical and histopathology reports for the diagnosis of nongangrenous versus gangrenous appendicitis. The sensitivity, specificity, and predictive values of CT intraluminal gas in gangrenous appendicitis were calculated. Results. Our study identified 93 patients with nonperforated acute appendicitis who underwent surgery within the stated timeframe. Intraluminal gas in the appendix was identified in 26 patients (28%), of which 54% had macroscopic and/or microscopic evidence of gangrenous appendicitis. This is in contrast to the subgroup of patients who did not have intraluminal gas (72%), of which only 33% had gangrenous appendicitis. The specificity of intraluminal gas for gangrenous appendicitis is 79%, with a negative predictive value of 86% and likelihood ratio of 1.85. Conclusion. In cases of established acute appendicitis, the presence of intraluminal gas is a moderately specific sign for gangrenous complication. This is worth reporting as it can help prognosticate and triage patients accordingly, for a timelier surgical management and a better outcome.http://dx.doi.org/10.1155/2021/7191348 |
| spellingShingle | Chantelle Ip Edward H. Wang Michael Croft Wanyin Lim Appendiceal Intraluminal Gas: A CT Marker for Gangrenous Appendicitis Radiology Research and Practice |
| title | Appendiceal Intraluminal Gas: A CT Marker for Gangrenous Appendicitis |
| title_full | Appendiceal Intraluminal Gas: A CT Marker for Gangrenous Appendicitis |
| title_fullStr | Appendiceal Intraluminal Gas: A CT Marker for Gangrenous Appendicitis |
| title_full_unstemmed | Appendiceal Intraluminal Gas: A CT Marker for Gangrenous Appendicitis |
| title_short | Appendiceal Intraluminal Gas: A CT Marker for Gangrenous Appendicitis |
| title_sort | appendiceal intraluminal gas a ct marker for gangrenous appendicitis |
| url | http://dx.doi.org/10.1155/2021/7191348 |
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