ArticleInsights into imaging2021
Predictive ability of CT findings in the differentiation of complicated and uncomplicated appendicitis: a retrospective investigation of 201 patients undergone appendectomy at initial admission.
Article in Insights into imaging, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 23 citations in OpenAlex.
- Association Between Age and Severity of Acute Appendicitis in Adults.Life (Basel, Switzerland) · 2026Article
- Appendicolith detection in dual-energy CT of adult acute appendicitis: comparing portovenous phase and virtual noncontrast with true noncontrast images.Abdominal radiology (New York) · 2026Article
- Article
- Low-keV virtual monoenergetic images with rapid kilovoltage-switching DECT for differentiating complicated from uncomplicated appendicitis in adults.Abdominal radiology (New York) · 2026Article
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- Article
- Factors associated with increased risk of perforation of acute appendicitis.Annals of medicine and surgery (2012) · 2026Article
- Retrospective analysis of 331 acute appendicitis patients: how appendicolith and CT features aid in differentiating complicated vs. uncomplicated appendicitis.BMC gastroenterology · 2025Article
- Article
- Predictive Value of Clinical and CT Scan Findings for Complicated Appendicitis: A Retrospective Analysis.Cureus · 2025Article
- CT of acute abdomen in the elderly.Insights into imaging · 2025Article
- Comparative study of imaging features in uncomplicated and complicated acute appendicitis.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2024Observational
- CT of appendicoliths in adult appendicitis: clinical significance and characteristics of overlooked cases.European radiology · 2024Article
- Validation of scoring systems for the prediction of complicated appendicitis in adults using clinical and computed tomographic findings.Insights into imaging · 2023Article
- Article
- Predictive value of sphericity index and other multidetector computed tomography findings in perforated acute appendicitis.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2023Article
- Application and curative effect of laparoscopic purse-string sutures in the treatment of adult acute complicated appendicitis.BMC surgery · 2023Article
- The Global Burden of Appendicitis in 204 Countries and Territories from 1990 to 2019.Clinical epidemiology · 2022Article
- External Validation of Adult Prediction Models for Complicated Appendicitis After Contrast-Enhanced Computed Tomography: A Single-Centre Study.ANZ journal of surgeryArticle
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundParadigm shift toward nonoperative management (NOM) of adult appendicitis has made computed tomography (CT) more important than ever, particularly in differentiating complicated from uncomplicated disease. Complete surgical and pathological data of appendicitis in a place where appendectomy at initial admission is a standard of care would allow retrospective review of preoperative CT for performance and predictive ability in identifying those that may benefit from NOM in the future.
resultsThe study included 201 CT scans of consecutive adult patients who presented for appendectomy at initial admission with pathologically confirmed acute appendicitis. Complicated appendicitis referred to gangrene or perforation on pathological or operative findings. The overall CT sensitivity, specificity and accuracy for differentiation of complicated from uncomplicated appendicitis were 87.2%, 75.7% and 81.1%, respectively. The most sensitive CT findings of complicated appendicitis were mucosal enhancement defect (83.2%; 95% CI 74.1-90.0) and moderate-to-severe periappendiceal fat stranding (96.8%; 95% CI 91.1-99.3), both independently predictive of complicated appendicitis with adjusted odds ratios (ORs) of 4.62 (95% CI 1.86-11.51) and 4.41 (95% CI 1.06-18.29), respectively. Phlegmon, fluid collection, extraluminal appendicolith, periappendiceal air and small bowel dilatation had specificity of 98.1-100%. Intraluminal appendicoliths were found more frequently in complicated appendicitis (52.6% vs. 22.6%) but not predictive for this diagnosis. Independent clinical predictors of complicated appendicitis were lack of pain migration (OR 2.06), neutrophilia ≥ 82% (OR (2.87) and symptoms ≥ 24 h (OR 5.84).
conclusionsCT findings were highly accurate in differentiating complicated from uncomplicated appendicitis among patients undergone appendectomy at initial admission.
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