Morphologic criteria of vermiform appendix on computed tomography and a possible risk of developing acute appendicitis

Abstract

Objective: To evaluate the correlation of morphological criteria of the cecal appendix using computed tomography (CT) and the possible risk of developing acute appendicitis. Materials and Methods: Cases were defined as patients with surgically confirmed acute appendicitis who had undergone CT at least twice: at diagnosis and at least one month prior. Controls were defined as emergency patients with abdominal pain who had undergone abdominal CT that excluded acute appendicitis and had also undergone CT at least one month before. Results: 100 cases and 100 controls were selected for inclusion in the final analysis. Comparisons between the cases and controls revealed the following: mean transverse diameter of 0.6 cm (range, 0.4-1.0 cm) versus 0.6 cm (range, 0.6-0.8 cm; p = 0.37); mean length of 6.6 cm (range, 3.5-9.7 cm) versus 6.6 cm (range, 4.5-8.3 cm; p = 0.87); mean angle of 100° (range, 23-178°) versus 86° (range, 43-160°; p = 0.01); vertical descending orientation in 56% versus 45% (p = 0.2); absence of gas in 69% versus 77% (p = 0.34); and presence of an appendicolith in 17% versus 8% (p = 0.08). Conclusion: Hypothetical risk factors for obstruction of the vermiform appendix detected on CT were not associated with acute appendicitis. That suggests that factors other than those related to mechanical obstruction are implicated in the pathogenesis of acute appendicitis.

Appendiceal wall thickness and Alvarado score are predictive of acute appendicitis in the patients with equivocal computed tomography findings

“…Appendiceal enlargement can be an isolated finding of appendicitis and was reported in up to 48% of symptomatic individuals 12 . The diameter cut-off of 6 mm was helpful to diagnose appendicitis 12 , 20 , 25 . In their study, appendicitis was not found in any patients who had appendiceal diameter less than 6 mm.…”

Asociación entre el diámetro apendicular tomográfico y el diagnóstico anatomopatológico de apendicitis aguda en el Hospital Militar Central entre 2015-2019

“…Cabe mencionar que, existen estudios realizados en población sin sospecha clínica de apendicitis, donde se ha encontrado que en el 42% de pacientes, el diámetro apendicular normal puede llegar de 6 a 10 mm, atribuyendo estos valores a la presencia de contenido como aire intraluminal. Por lo tanto, el diámetro apendicular tomográfico aumentado, en un escenario de pacientes sin alta sospecha clínica de apendicitis aguda, podría conducir a resultados falsos positivos [28][29][30][31] .…”