The CT diagnosis of acute appendicitis

Abstract

In clinically equivocal cases of acute appendicitis, CT performed after the opacification of the terminal ileum and the cecum offers a significant improvement in diagnostic accuracy when compared to diagnosis based on clinical signs and symptoms alone. The method employed to opacify the bowel has been the subject of discussion in the literature. We believe that the oral administration of contrast, without the use of rectal or intravenous contrast, provides the best combination of diagnostic accuracy and convenience. The CT signs of acute appendicitis are described. Ways of minimizing the difficulties of diagnosing a ruptured appendix are discussed. Because of the radiation involved, CT should not be used routinely in acute appendicitis, but should be reserved for clinically equivocal cases.