Evidence map›Paper›PMID 39498711›Full record

Observational studyUlusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES2024

Challenges and predictive radiological findings in the diagnosis of neuroendocrine tumors in patients with acute appendicitis.

Osman Şimşek, Sabri Şirolu, Yağmur Özkan Irmak, Rauf Hamid, Sefa Ergun, Nuray Kepil, Onur Tutar

Abstract readObservational Study
In one paragraph

Observational study in Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Osman ŞimşekDepartment of General Surgery, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul-Türkiye.
Sabri ŞiroluDepartment of Radiology, Sisli Hamidiye Etfal Training and Research Hospital, Sisli, İstanbul-Türkiye.
Yağmur Özkan IrmakDepartment of Radiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul-Türkiye.
Rauf HamidDepartment of Radiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul-Türkiye.
Sefa ErgunDepartment of General Surgery, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul-Türkiye.
Nuray KepilDepartment of Pathology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul-Türkiye.
Onur TutarDepartment of Radiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul-Türkiye.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute appendicitis is one of the most common surgical emergencies. With antibiotic-first treatment strategies gaining importance, the risk of an appendiceal tumor as an incidental finding or as the cause of appendicitis presents an obstacle to a conservative approach. Neuroendocrine tumors, the most frequent type of appendiceal tumors, are difficult to diagnose preopera-tively due to their small size. This study aims to identify predictive factors for neuroendocrine tumors in patients undergoing surgery for acute appendicitis by analyzing imaging and clinical characteristics, thereby enhancing preoperative diagnostic accuracy and guiding surgical interventions.

methodsThis retrospective observational study included 1,298 patients who underwent appendectomy from January 2014 to May 2024. After excluding 59 patients with normal pathology results, 40 with variable pathologies, and 49 with inaccessible computed tomography (CT) images, 1,150 patients remained (1,135 with acute appendicitis and 15 with neuroendocrine tumors). Abdominal CT scans were evaluated for appendiceal diameter, wall thickness, cecal wall thickness, periappendiceal fat stranding, fluid collection, lymphadenopathy, intraluminal and free periappendiceal air, mucosal hyperenhancement, the presence of appendicolith, mural calcification, and mural nodules.

resultsThe presence of a mural nodule protruding into the lumen was significantly higher in neuroendocrine tumor patients compared to those with acute appendicitis, with a sensitivity of 53.3%, specificity of 95.8%, positive predictive value (PPV) of 31.9%, negative predictive value (NPV) of 99.4%, and accuracy of 97.9%. Intraluminal air was also more frequent in neuroendocrine tumor patients, with a sensitivity of 53.3%, specificity of 76.7%, PPV of 2.9%, NPV of 99.2%, and accuracy of 76.4%. Other imaging parameters did not show significant differences between the two groups.

conclusionThis study identifies mural nodules and intraluminal air as significant predictors of neuroendocrine tumors in patients with acute appendicitis, emphasizing the importance of meticulous preoperative imaging evaluations. Incorporating these predictors into diagnostic protocols could improve the preoperative identification of neuroendocrine tumors, enabling more appropriate surgical interventions. Future research should validate these findings through prospective studies and explore advanced imaging techniques to further enhance the detection of appendiceal neoplasms, ultimately improving patient outcomes and reducing overlooked malignancies.

Indexed as

Appendiceal NeoplasmsAppendicitisNeuroendocrine TumorsTomography, X-Ray ComputedAcute DiseaseAdolescentAdultAgedAppendectomyFemaleHumansMaleMiddle AgedPredictive Value of TestsRetrospective StudiesYoung Adult

Identifiers

PMID39498711
PMCPMC11843387

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.