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Evidence summaries

Computed Tomography for Diagnosis of Acute Appendicitis in Adults

The sensitivity and specificity of CT for diagnosing appendicitis in adults are high. Unenhanced standard-dose CT appears to have lower sensitivity than standard-dose CT with intravenous, rectal, or oral and intravenous contrast enhancement. Level of evidence: "A"

Summary

A Cochrane review [Abstract]1 included 64 studies with a total of 10.280 participants (4583 with and 5697 without acute appendicitis). At the median prevalence of appendicitis (0.43), the probability of having appendicitis following a positive CT result was 0.92 (95% CI 0.90 to 0.94), and the probability of having appendicitis following a negative CT result was 0.04 (95% CI 0.03 to 0.05). In subgroup analyses according to contrast enhancement, summary sensitivity was higher for CT with intravenous contrast (0.96, 95% CI 0.92 to 0.98), CT with rectal contrast (0.97, 95% CI 0.93 to 0.99), and CT with intravenous and oral contrast enhancement (0.96, 95% CI 0.93 to 0.98) than for unenhanced CT (0.91, 95% CI 0.87 to 0.93).

Links

SOF Table http://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009977.pub2/full#CD009977-sec1-0001

Abstract in McMaster database

References

  • Rud B, Vejborg TS, Rappeport ED et al. Computed tomography for diagnosis of acute appendicitis in adults. Cochrane Database Syst Rev 2019(11):CD009977. [PubMed]

Primary/Secondary Keywords