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REVIEW ARTICLE
Year : 2011  |  Volume : 1  |  Issue : 1  |  Page : 49

Imaging Acute Appendicitis: State of the Art


Department of Medical Imaging, Unit of Ultrasound, Rambam Health Care Center and Bruce Rappaport Faculty of Medicine, Israel Institute of Technology, Haifa, Israel

Correspondence Address:
Diana Gaitini
Unit of Ultrasound, Department of Medical Imaging, Rambam Medical Center, Ha'aliya 8, POB 9602, Haifa
Israel
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2156-7514.85778

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The goal of this review is to present the state of the art in imaging tests for the diagnosis of acute appendicitis. Relevant publications regarding performance and advantages/disadvantages of imaging modalities for the diagnosis of appendicitis in different clinical situations were reviewed. Articles were extracted from a computerized database (MEDLINE) with the following activated limits: Humans, English, core clinical journals, and published in the last five years. Reference lists of relevant studies were checked manually to identify additional, related articles. Ultrasound (US) examination should be the first imaging test performed, particularly among the pediatric and young adult populations, who represent the main targets for appendicitis, as well as in pregnant patients. A positive US examination for appendicitis or an alternative diagnosis of possible gastrointestinal or urological origin, or a negative US, either showing a normal appendix or presenting low clinical suspicion of appendicitis, should lead to a final diagnosis. A negative or indeterminate examination with a strong clinical suspicion of appendicitis should be followed by a computed tomography (CT) scan or alternatively, a magnetic resonanace imaging (MRI) scan in a pregnant patient. A second US examination in a patient with persistent symptoms, especially if the first one was performed by a less experienced imaging professional, is a valid alternative to a CT.


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