The use of helical computed tomography in pregnancy for the diagnosis of acute appendicitis

Castro, Mary Ames; Shipp, Thomas; Castro, Eduardo Camelo de; Ouzounian, Joseph G.; Rao, Patrick M.

doi:10.1067/mob.2001.111721

Cited by 99 publications

(37 citation statements)

References 12 publications

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“…40 The initial experience with helical computed tomography for the diagnosis of appendicitis in pregnancy seems promising, but the data are limited to small series of cases. 39 Changes to the CT protocol can limit exposure to fetal radiation estimated at less than 3 mGy, well below the doses related to adverse fetal effects (30 mGy for the risk of carcinogenesis, 50 mGy for deterministic effects) 36,40 without limiting diagnostic performance. 39,41 A digital abdominal CT protocol with a preparation of intravenous and oral contrast, especially for the visualization of the appendix, may also be used but is associated with increased fetal exposure to radiation (20 to 40 mGy).…”

Section: 28mentioning

confidence: 99%

“…39 Changes to the CT protocol can limit exposure to fetal radiation estimated at less than 3 mGy, well below the doses related to adverse fetal effects (30 mGy for the risk of carcinogenesis, 50 mGy for deterministic effects) 36,40 without limiting diagnostic performance. 39,41 A digital abdominal CT protocol with a preparation of intravenous and oral contrast, especially for the visualization of the appendix, may also be used but is associated with increased fetal exposure to radiation (20 to 40 mGy). 40,42 CT is indicated when the clinical findings and ultrasound results are inconclusive and MRI is not available, given the proven diagnostic value of CT in non-pregnant persons: overall sensitivity of 94% (CI 95% 91-95%), specificity of 95% (CI 95% 93-96%), positive predictive value of 13.3% (CI 95% 9.9-17.9%) and negative predictive value of 0.09% (CI 95% 0.07-0.12%).…”

Section: 28mentioning

confidence: 99%

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Acute appendicitis in pregnancy: literature review

Neto

Amorim²,

Nóbrega³

2015

Rev. Assoc. Med. Bras.

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Conflict of interest: noneIntroduction: suspected appendicitis is the most common indication for surgery in non-obstetric conditions during pregnancy and occurs in about one in 500 to one in 635 pregnancies per year. This occurs more often in the second trimester of pregnancy. Acute appendicitis is the most common general surgical problem encountered during pregnancy. Methods: a literature review on research of scientific articles, under the terms "acute appendicitis" and "pregnancy", in PubMed, Lilacs/SciELO, Scopus, Cochrane Library and Uptodate databases.Results: the clinical manifestations of appendicitis are similar to non-pregnant women, however, without a classic presentation, which often occurs, diagnosis is difficult and must be supported by imaging. Discussion: clinical diagnosis should be strongly suspected in pregnant women with classic findings such as abdominal pain that migrates to the right lower quadrant. The main purpose of imaging is to reduce delays in surgical intervention due to diagnostic uncertainty. A secondary objective is to reduce, but not eliminate, the negative appendectomy rate. Differential diagnosis of suspected acute appendicitis usually includes pathologies considered in non-pregnant people. Conclusion: the imaging study of choice is ultrasound, MRI may be used when the former is not conclusive and, as a last resort, a CT scan can be performed. The treatment remains appendectomy by laparotomy, since the feasibility of video-assisted surgery in these cases remains controversial.

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Section: 28mentioning

confidence: 99%

Section: 28mentioning

confidence: 99%

Acute appendicitis in pregnancy: literature review

Neto

Amorim²,

Nóbrega³

2015

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

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“…[4,[13][14][15] Wallace et al [10] reported an overall negative appendectomy rate of 37% for pregnant patients with presumed acute appendicitis. They also reported no difference in the negative appendectomy rate with the addition of CT scan after US.…”

Section: Discussionmentioning

confidence: 99%

Management of Acute Appendicitis in Pregnancy

Kapan¹,

Bozkurt²,

Turhan³

et al. 2013

Ulus Travma Acil Cerrahi Derg

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“…Use of the helical CT makes it possible to reduce the scan time in some conditions, thereby lowering the dose of radiation as compared to a standard CT [24] . Ames Castro et al [25] reported that with the use of the helical CT in pregnancy for the diagnosis of acute appendicitis, radiation exposure was approximately 3 mGy. This dose is in the same range that the fetus would normally receive from background radiation, e.g.…”

Section: Discussionmentioning

confidence: 99%

Prenatal Three-Dimensional Images of Proximal Focal Femoral Deficiency Produced by Helical Computed Tomography

et al. 2009

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Introduction: Proximal focal femoral deficiency (PFFD) is a rare skeletal disorder characterized by failure in development of the subtrochanteric region of the femoral shaft, with varying degrees of shortening of the proximal femur. Objective: To investigate the potential of helical computed tomography as a prenatal diagnostic tool for bony abnormalities. Case: A 37-year-old Japanese woman was referred to our hospital at 32 weeks of gestation for the evaluation of fetal growth restriction with short femurs. An ultrasound examination revealed the fetus to have short femurs bilaterally with normal echogenicity, and a normal facial profile. Assessment by 3D CT confirmed the absence of the femoral heads bilaterally and also revealed bilateral hip dislocations and oligodactyly of the right hand. The baby was delivered by cesarean section at 37 weeks of gestation, whereupon the diagnosis of PFFD was confirmed. Conclusion: Helical CT is a useful prenatal diagnostic alternative for bony abnormalities that is superior to the conventional sonographic approach.

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The use of helical computed tomography in pregnancy for the diagnosis of acute appendicitis

Cited by 99 publications

References 12 publications

Acute appendicitis in pregnancy: literature review

Acute appendicitis in pregnancy: literature review

Management of Acute Appendicitis in Pregnancy

Prenatal Three-Dimensional Images of Proximal Focal Femoral Deficiency Produced by Helical Computed Tomography

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