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World Journal of Emergency Surgery

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Open Access 01-12-2014 | Research article

Important CT findings for prediction of severe appendicitis: involvement of retroperitoneal space

Authors: Kumiko Kitaoka, Kazuhiro Saito, Koichi Tokuuye

Published in: World Journal of Emergency Surgery | Issue 1/2014

Abstract

Background

Determination of the severity of appendicitis and differentiation between complicated and uncomplicated appendicitis are clinically important. Severe appendicitis frequently affects extraperitoneal spaces. We have investigated CT findings of retroperitoneal space (RPS) in patients with appendicitis to create a model for identification of complicated appendicitis.

Method

CT images of 223 patients with pathologically proven appendicitis were reviewed. The total number of the segments in RPS where inflammatory changes were located (RPS count) was obtained as well as appendiceal diameter, appendicolithiasis, WBC count, and CRP level. Data were analyzed to identify factors indicating complicated appendicitis. Univariate analysis was conducted to identify statistically significant variables. A multivariable logistic regression analysis was performed in order to find independent predictors of complicated appendicitis.

Results

Patients with complicated appendicitis were more likely to have higher RPS count (P < 0.001), appendicolithiasis (P = 0.002), higher CRP level (P < 0.001), and greater appendix diameter (P < 0.001) than patients with uncomplicated appendicitis. Statistical analysis showed RPS count was the most helpful predictor of complicated appendicitis.

Conclusion

Radiologists and surgeons should be aware of the importance of CT findings in RPS when treating patients with appendicitis. Complicated appendicitis can be predicted by RPS count, diameter of the appendix, appendicolithiasis, and CRP level.

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Title: Important CT findings for prediction of severe appendicitis: involvement of retroperitoneal space
Authors: Kumiko Kitaoka
Kazuhiro Saito
Koichi Tokuuye
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: World Journal of Emergency Surgery / Issue 1/2014
Electronic ISSN: 1749-7922
DOI: https://doi.org/10.1186/1749-7922-9-62

At a glance: The STEP trials

Springer Medicine

Important CT findings for prediction of severe appendicitis: involvement of retroperitoneal space

Abstract

Background

Method

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Method

Results

Conclusion

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