Clinical guidelines, computed tomography scan, and negative appendectomies: a case series

Harswick, Chad; Uyenishi, Amy Archer; Kordick, Mary Frances; Chan, S.B.

doi:10.1016/j.ajem.2005.07.015

Cited by 29 publications

(16 citation statements)

References 21 publications

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“…Whereas recent studies suggest that the negative appendectomy rate when CT is selectively utilised is approximately 5–10%,23 the negative appendectomy rate in our study was only 1.1%. This improvement can be partly attributable to the improved resolution of 16-slice MDCT versus older imaging technology.…”

Section: Discussioncontrasting

confidence: 99%

Impact of helical computed tomography in clinically evident appendicitis

Kim

Rhee

Lee

et al. 2008

Emergency Medicine Journal

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Section: Discussioncontrasting

confidence: 99%

Impact of helical computed tomography in clinically evident appendicitis

Kim

Rhee

Lee

et al. 2008

Emergency Medicine Journal

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“…The falsepositive rate for clinical diagnosis of acute appendicitis with subsequent removal of a normal appendix is as high as 25%. 1 This false-positive rate is felt to be justified due to the morbidity and mortality associated with appendiceal perforation.…”

Section: Possible Answersmentioning

confidence: 99%

Abdominal Pain in an 8-Year-Old Male

Carter

Nelson

Mizell

2007

Laboratory Medicine

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“…Often stool culture results take time to produce, and waiting for these results may put the patient at a high risk of appendiceal perforation 5 . Despite the high false-positive rate, surgery is often justified due to the morbidity and mortality associated with appendiceal perforation 6 . Secondly, there is minimal literature suggesting eosinophilia and elevated serum immunoglobulin E levels as features of nematode infections, this may or may not be true, but these are non-specific markers and our patient had normal levels 5 …”

Section: Discussionmentioning

confidence: 99%

Nematode infection: A rare mimic of acute appendicitis

Hotchen

Chin

Raja

2014

International Journal of Surgery Case Reports

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INTRODUCTIONAcute appendicitis is a common condition seen in all surgical units. One rare condition that can mimic acute appendicitis is a nematode infection of the bowel. There have been few reported cases of nematode infection within the appendix and none that have been accompanied by intra-operative pictures.PRESENTATION OF CASEA 16-year-old female presented with a 12 h history of right iliac fossa pain and mild pyrexia. Bloods showed a neutrophilia and normal C-reactive protein. Laparoscopy was performed which revealed a non-inflamed appendix. The appendix was dissected and a live nematode was visualised exiting the base of the appendix. Anti-helminthics were given and the infection resolved.DISCUSSIONNematode infection is most commonly seen in Africa, Asia and South America. When seen within the United Kingdom (UK), it is seen most commonly within high-risk populations. Testing for these infections is not routine within the UK and when they are performed, the results take a considerable amount of time to return. These tests should be considered within high-risk populations so that unnecessary surgery can be avoided.CONCLUSIONThis case highlights the importance of considering rare causes of right iliac fossa pain including nematode infection in a young patient. The case highlights this by giving intra-operative pictures of live nematodes upon dissection of the appendix.

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Clinical guidelines, computed tomography scan, and negative appendectomies: a case series

Cited by 29 publications

References 21 publications

Impact of helical computed tomography in clinically evident appendicitis

Impact of helical computed tomography in clinically evident appendicitis

Abdominal Pain in an 8-Year-Old Male

Nematode infection: A rare mimic of acute appendicitis

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